Rapid assessment of Hib disease burden in Vietnam

Batmunkh Nyambat,Paul E Kilgore,Duc Anh Dang,Mary Pe Slack,Hien Anh Nguyen,Trinh Quynh Mai,Manju Rani

doi:10.1186/1471-2458-11-260

Abstract

BackgroundSeveral countries have applied the Haemophilus influenzae type b (Hib) rapid assessment tool (RAT) to estimate the burden of Hib disease where resources for hospital- or population-based surveillance are limited. In Vietnam, we used the Hib RAT to estimate the burden of Hib pneumonia and meningitis prior to Hib vaccine introduction.MethodsLaboratory, hospitalization and mortality data were collected for the period January 2004 through December 2005 from five representative hospitals. Based on the WHO Hib RAT protocol, standardized MS Excel spreadsheets were completed to generate meningitis and pneumonia case and death figures.ResultsWe found 35 to 77 Hib meningitis deaths and 441 to 957 Hib pneumonia deaths among children < 5 years of age annually in Vietnam. Overall, the incidence of Hib meningitis was estimated at 18/100,000 (95% confidence interval, CI, 15.1-21.6). The estimated Hib meningitis incidence in children < 5 years age was higher in Ho Chi Minh City (22.5/100,000 [95% CI, 18.4-27.5]) compared to Hanoi (9.8/100,000 [95% CI, 6.5-14.8]). The Hib RAT suggests that there are a total of 883 to 1,915 cases of Hib meningitis and 4,414 to 9,574 cases of Hib pneumonia per year in Vietnam.ConclusionsIn Hanoi, the estimated incidence of Hib meningitis for children < 5 years of age was similar to that described in previous population-based studies of Hib meningitis conducted from 1999 through 2002. Results from the Hib RAT suggest that there is a substantial, yet unmeasured, disease burden associated with Hib pneumonia in Vietnamese children.

Highlights

Several countries have applied the Haemophilus influenzae type b (Hib) rapid assessment tool (RAT) to estimate the burden of Hib disease where resources for hospital- or population-based surveillance are limited
Hib meningitis exacts high costs from the health-care system and society due to its severity and associated long-term sequelae, it is believed that the majority of Hib disease in developing countries is manifested as pneumonia [12,13]
Purulent, and confirmed bacterial and Hib meningitis Based on available data from the three children’s hospitals in Hanoi during the two-year study period from January 2004 through December 2005, we found 145 cases of suspected meningitis, 85 cases of purulent meningitis, including 17 cases with a bacterial pathogen identified, and 10 cases in which Hib was detected (Table 2)

Summary

Introduction

Several countries have applied the Haemophilus influenzae type b (Hib) rapid assessment tool (RAT) to estimate the burden of Hib disease where resources for hospital- or population-based surveillance are limited. Prior to the introduction of universal childhood immunization with Haemophilus influenzae type b (Hib) vaccine, Hib was the most common cause of lifethreatening bacterial infection (most often resulting in meningitis, bacterial pneumonia, and sepsis) in young children in industrialized countries [1]. Relatively few studies have documented the burden of Hib disease among Asian children [9,10]. This limited evidence has hindered the introduction of Hib vaccines in some countries. Hib meningitis exacts high costs from the health-care system and society due to its severity and associated long-term sequelae, it is believed that the majority of Hib disease in developing countries is manifested as pneumonia [12,13]

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