Abstract
To document the incidence and the descriptive epidemiology of bacterial meningitis among individuals under age 20 in a geographically defined region in Brazil during the two-year period immediately preceding the introduction of Haemophilus influenzae type b (Hib) vaccines into the national immunization program of Brazil. Population-based epidemiological study of all cases of bacterial meningitis reported among residents of Campinas, Brazil, under age 20 (n=316,570) during the period of 1997-98, using comprehensive surveillance records compiled by the Campinas Health Department from cases reported among hospital inpatients, outpatients, emergency room visits, death certificates, and autopsy reports. The incidence of bacterial meningitis (n=274) was 334.9, 115 and 43.5 cases/10(5) person-years (pys) for residents of Campinas under age 1, 5 and 20, respectively. All cases were hospitalized, with an average length of stay of 12 days. Documented prior antibiotic use was 4.0%. The case-fatality rate of bacterial meningitis in individuals under age 20 was 9% (24/274) with 75% of deaths occurring in children under the age of five. The incidence of Hib meningitis (n=26) was 62.8 and 17 cases/10(5) pys in children age <1 and <5, respectively. The incidence of Hib meningitis in children under the age of 5 in Campinas during 1997-98 was similar to that reported in the US, Western Europe, and Israel prior to widespread Hib vaccine use in those regions. This study provides a baseline for later studies to evaluate changes in the etiology and incidence of bacterial meningitis in children after introduction of routine Hib vaccination in Brazil.
Highlights
Bacterial infections remain an important cause of morbidity and mortality in children despite the availability of highly effective antibiotics
In the United States, before the era of Haemophilus influenzae type b (Hib) vaccines, more than 70% of bacterial meningitis among children less than five years old was attributable to Hib.[19]
Published data from the U.S show that the incidence of Hib meningitis among children under 5 years of age decreased from 25 cases per 10,5 in 1984, to less than 2.5 cases per 105 in 1993 after the introduction of conjugate vaccines since 1988.21 In Brazil, several studies have been performed over the past ten years evaluating the etiology, treatment, or outcomes of bacterial meningitis in newborns and children.[2,5,7,10,14,18]
Summary
Bacterial infections remain an important cause of morbidity and mortality in children despite the availability of highly effective antibiotics. In Brazil, several studies have been performed over the past ten years evaluating the etiology, treatment, or outcomes of bacterial meningitis in newborns and children.[2,5,7,10,14,18] only limited information on the etiology, incidence and treatment outcomes of bacterial meningitis in geographically defined regions are available. The present study was conducted to provide an overview of the etiology, incidence rates, antimicrobial use, and outcome of reported bacterial meningitis cases among children in Campinas, SP, Brazil, during a two-year period immediately preceding the implementation of the Hib vaccination as a part of the national immunization program in July 1999. The information may serve as a baseline for further studies to evaluate the effectiveness of the Hib vaccination program
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
