title: Vaccine preventable meningitis in Malaysia: epidemiology and management.
abstract: Worldwide bacterial meningitis accounts for more than one million cases and 135,000 deaths annually. Profound, lasting neurological complications occur in 9-25% of cases. This review confirms the greatest risk from bacterial meningitis is in early life in Malaysia. Much of the disease burden can be avoided by immunization, particularly against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae. Despite inclusion of the Hib vaccine in the National Immunisation Programme and the licensure of pneumococcal vaccines, these two species are the main contributors to bacterial meningitis in Malaysia, with Neisseria meningitidis and Mycobacterium tuberculosis, causing a smaller proportion of disease. The high Hib prevalence may partly be due to dated, small-scale studies limiting the understanding of the current epidemiological situation. This highlights the need for larger, better quality surveillance from Malaysia to evaluate the success of Hib immunization and to help guide immunization policy for vaccines against S. pneumoniae and N. meningitidis.
authors.affiliation: University of Southampton Malaysia Campus, No.3, Persiaran Canselor 1, Kota Ilmu, Educity, Iskandar, 79200 Nusajaya, Johor, Malaysia.
authors.forename: Hannah C
authors.initials: HC
authors.lastname: McNeil
authors.affiliation: Faculty of Medicine and Institute of Life Sciences, University of Southampton, Southampton, UK
authors.forename: Johanna M C
authors.initials: JM
authors.lastname: Jefferies
authors.affiliation: University of Southampton Malaysia Campus, No.3, Persiaran Canselor 1, Kota Ilmu, Educity, Iskandar, 79200 Nusajaya, Johor, Malaysia.|Faculty of Medicine and Institute of Life Sciences, University of Southampton, Southampton, UK
authors.forename: Stuart C
authors.initials: SC
authors.lastname: Clarke
mesh_terms: D000367:Age Factors; D016667:Bacterial Capsules; D017281:Cost of Illness; D019468:Disease Management; D018073:Haemophilus Vaccines / Q000627:therapeutic use*; D019741:Haemophilus influenzae type b; D006801:Humans; D017589:Immunization Programs; D008296:Malaysia / Q000453:epidemiology; D016920:Meningitis, Bacterial / Q000145:classification / Q000401:mortality / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000627:therapeutic use*; D013296:Streptococcus pneumoniae; D014611:Vaccination
chemical_list: D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine; D022242:Pneumococcal Vaccines
keywords: Haemophilus influenzae; Malaysia; Mycobacterium tuberculosis; Neisseria meningitides; Streptococcus pneumoniae; disease surveillance; etiology; immunization; meningitis