Abstract
Ensuring the effectiveness of the Haemophilus influenza type b (DTwP-Hib-HepB) vaccine in reducing meningitis is an essential approach in evaluating the effectiveness of the vaccine. The study aimed to address the epidemiology of meningitis following pentavalent vaccination in Iran. Data on meningitis patients from 21st March 2011 to 21st July 2018 were extracted from the National Notifiable Diseases Surveillance System. This information was divided into two equal periods before the pentavalent vaccine introduction (21st March 2011 to 17th November 2014) and after the introduction (18th November 2014 to 21st July 2018). The number of patients in the study period was 53,174 cases. More than 55% of patients were under 5 years old. Males (63.34%) were more than females (36.06%). The death rate was reduced to 2.1%; also, the proportion of confirmed cases caused by H. influenzae type b was 6.7% before the pentavalent vaccine introduction. The corresponding value following vaccine introduction equals to 3.6%. The proportion of children under five has decreased from 4.4% to 1.9%. This value indicates a 46.2% decrease in the meningitis of all ages and a 57% decrease in children under five dues to H. influenzae vaccination. The results of the study indicate the effectiveness of the vaccine due to changes in meningitis caused by H. influenzae type b after vaccination compared with no vaccination. Therefore, it is advisable to continue the full immunization coverage with the pentavalent vaccine.
Highlights
Meningitis is a disease caused by inflammation of the protective lining of the brain and spinal cord called meninges [1]
53,174 cases from 1-day to 110-year-old patients with meningitis were enrolled, which 28,471 were pre-vaccinated with the H. influenzae type b vaccine, and 24,703 cases were after vaccination implementation
The results of this study show that out of 95 confirm patients diagnosed with H. influenzae type b, 91 cases (95.8%) did not receive the H. influenza vaccine, and only four cases (4.2%) received the vaccine
Summary
Meningitis is a disease caused by inflammation of the protective lining of the brain and spinal cord called meninges [1]. Bacterial meningitis can be caused by a variety of factors, including S. pneumonia, N. meningitis, and H. influenzae. Failure to receive the H. influenzae vaccine is one of the most important causes of meningitis in children under 5 years of age [5]. Given the significant burden of disease caused by these agents, the World Health Organization has recommended adding the H. influenza type b, Hib vaccine to the countries’ immunization program. Like many developing countries and to reduce the number of cases of pneumonia and subsequent meningitis, Iran has added the pentavalent (DTwP-Hib-HepB) vaccine to the routine immunization program at 2, 4 and 6 months old age since 18th November 2014 [6,7,8,9,10,11]. The rate of vaccination coverage in the target groups is 99% [12,13]
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