title: Impact of introduction of the Haemophilus influenzae type b conjugate vaccine into childhood immunization on meningitis in Bangladeshi infants.
abstract: OBJECTIVE
  Some Asian countries have been reluctant to adopt Haemophilus influenzae type b (Hib) conjugate vaccination because of uncertainty over disease burden. We assessed the impact of introduction of Hib conjugate vaccine into the Expanded Program on Immunization in Bangladesh on purulent and laboratory-confirmed H influenzae meningitis.
  
  
  METHODS
  Within a well-defined catchment area around 2 surveillance hospitals in Dhaka, Bangladesh, we compared the incidence of Hib meningitis confirmed by culture, latex agglutination, and polymerase chain reaction assay among infants 1 year before and 1 year after introduction of Hib conjugate vaccine. We adjusted the incidence rate for the proportion of children who sought care at the surveillance hospitals.
  
  
  RESULTS
  Among infants, the incidence of confirmed Hib meningitis decreased from 92-16 cases per 100,000 within 1 year of vaccine introduction (vaccine preventable incidence = 76; 95% CI 18, 135 per 100,000). The incidence of purulent meningitis decreased from 1659-1159 per 100,000 (vaccine preventable incidence = 500; 95% CI: 203, 799 per 100,000). During the same time period, there was no significant difference in the incidence of meningitis due to Streptococcus pneumoniae.
  
  
  CONCLUSIONS
  Introduction of conjugate Hib conjugate vaccine into Bangladesh Expanded Program on Immunization markedly reduced the burden of Hib and purulent meningitis.
authors.affiliation: International Center for Diarrheal Disease Research-B, Dhaka, Bangladesh.
authors.forename: Nadira K
authors.initials: NK
authors.lastname: Sultana
authors.forename: Samir K
authors.initials: SK
authors.lastname: Saha
authors.forename: Hassan M
authors.initials: HM
authors.lastname: Al-Emran
authors.forename: Joyanta K
authors.initials: JK
authors.lastname: Modak
authors.forename: M A Yushuf
authors.initials: MA
authors.lastname: Sharker
authors.forename: Shams
authors.initials: S
authors.lastname: El-Arifeen
authors.forename: Adam L
authors.initials: AL
authors.lastname: Cohen
authors.forename: Abdullah H
authors.initials: AH
authors.lastname: Baqui
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Luby
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D005260:Female; D018073:Haemophilus Vaccines / Q000008:administration & dosage*; D006801:Humans; D017589:Immunization Programs; D015994:Incidence; D007223:Infant; D008297:Male; D016920:Meningitis, Bacterial / Q000453:epidemiology* / Q000517:prevention & control; D008583:Meningitis, Haemophilus / Q000453:epidemiology* / Q000517:prevention & control; D018074:Vaccines, Conjugate / Q000008:administration & dosage*
chemical_list: D018073:Haemophilus Vaccines; D018074:Vaccines, Conjugate