title: Effect of vaccines on bacterial meningitis worldwide.
abstract: Three bacteria--Haemophilus influenzae, Streptococcus pneumoniae, and Neisseria meningitidis--account for most acute bacterial meningitis. Measurement of the effect of protein-polysaccharide conjugate vaccines is most reliable for H influenzae meningitis because one serotype and one age group account for more than 90% of cases and the incidence has been best measured in high-income countries where these vaccines have been used longest. Pneumococcal and meningococcal meningitis are caused by diverse serotypes and have a wide age distribution; measurement of their incidence is complicated by epidemics and scarcity of surveillance, especially in low-income countries. Near elimination of H influenzae meningitis has been documented after vaccine introduction. Despite greater than 90% reductions in disease attributable to vaccine serotypes, all-age pneumococcal meningitis has decreased by around 25%, with little data from low-income settings. Near elimination of serogroup C meningococcal meningitis has been documented in several high-income countries, boding well for the effect of a new serogroup A meningococcal conjugate vaccine in the African meningitis belt.
authors.affiliation: National Centre for Immunisation Research and Surveillance of Vaccine-Preventable Diseases, The Children's Hospital at Westmead and the University of Sydney, Sydney, NSW, Australia. peter.mcintyre@health.nsw.gov.au
authors.forename: Peter B
authors.initials: PB
authors.lastname: McIntyre
authors.forename: Katherine L
authors.initials: KL
authors.lastname: O'Brien
authors.forename: Brian
authors.initials: B
authors.lastname: Greenwood
authors.forename: Diederik
authors.initials: D
authors.lastname: van de Beek
mesh_terms: D001428:Bacterial Vaccines; D002986:Clinical Trials as Topic; D017281:Cost of Illness; D019049:Developed Countries; D003906:Developing Countries; D005544:Forecasting; D014943:Global Health; D016905:Gram-Negative Bacterial Infections / Q000517:prevention & control*; D016908:Gram-Positive Bacterial Infections / Q000517:prevention & control*; D006192:Haemophilus Infections / Q000517:prevention & control; D006193:Haemophilus influenzae; D006801:Humans; D032521:Immunity, Herd; D007115:Immunization Schedule; D016920:Meningitis, Bacterial / Q000453:epidemiology / Q000517:prevention & control*; D008585:Meningitis, Meningococcal / Q000517:prevention & control; D009345:Neisseria meningitidis; D011008:Pneumococcal Infections / Q000517:prevention & control; D013296:Streptococcus pneumoniae; D016896:Treatment Outcome
chemical_list: D001428:Bacterial Vaccines