HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Sow, S. O. Articles by Levine, M. M. PubMed PubMed Citation Articles by Sow, S. O. Articles by Levine, M. M. Pubmed/NCBI databases Substance via MeSH

Haemophilus influenzae Type b Conjugate Vaccine Introduction in Mali: Impact on Disease Burden and Serologic Correlate of Protection

In Bamako, Mali, where surveillance revealed a high incidence of Haemophilus influenzae type b (Hib) invasive disease, Hib conjugate vaccine was introduced into the Expanded Program on Immunization and the impact assessed. Annual confirmed Hib hospitalizations for infants 0–11 months of age fell from 175/10⁵ to 44/10⁵ (P < 0.001); among infants 6–7 months of age Hib hospitalizations fell from 377/10⁵ to 69/10⁵, (82% decrease, P < 0.001). Invasive Streptococcus pneumoniae hospitalizations remained unchanged. In a baseline serosurvey, only 3/200 infants 6–7 months of age (1.5%) had protective anti-polyribosylribitol phosphate (PRP) titers 0.15 µg/mL and 1(0.5%) had 1.0 µg/mL. In serosurveys 18 and 30 months after vaccine introduction, 168/201 (84%) and 184/200 (92%) infants, respectively, had titers 0.15 µg/mL and 141/201 (70%) and 163/200 (82%) had titers 1.0 µg/mL. Introduction of Hib vaccine led to rises in anti-PRP seroprevalence, significant reductions in Hib disease, and all-cause hospitalizations, whereas S. pneumoniae disease remained unchanged.

Received December 18, 2008. Accepted for publication February 11, 2009.

Acknowledgments: We thank Patrick Murray for invaluable early help in establishing the Clinical Bacteriology Laboratory at l’Hôpital Gabriel Touré, James D. Campbell for assistance in clinical activities, William C. Blackwelder for biostatistical assistance, and Mardi Reymann and Lilian Cuberos from the CVD Applied Immunology Section for technical assistance measuring Hib antibodies. During the period 2002–2008, the activities described in this report received enthusiastic support from the incumbent Ministers of Health (Fatoumata Nafo Traoré, Keita Rokiatou N’Diaye, Maiga Zeinab Mint Yuba, and Oumar Ibrahim Touré) and their respective Vice Ministers (Abdramane Tounkara, Mamadou Adama Kane, Daba Diawara, and Lansseni Konaté). We also acknowledge the staunch support for Hib vaccine introduction provided by His Excellency, Amadou Toumani Touré, President of the Republic of Mali.

Financial support: Grants from the Bill and Melinda Gates Foundation (#1187 and #32470) and a grant from the Rockefeller Foundation to M. M. Levine.

^* Address correspondence to Samba O. Sow, Centre pour le Développement des Vaccins – Mali, Ex-Institut Marchoux, Bamako, Mali, BP251. E-mail: ssow{at}medicine.umaryland.edu

Authors’ addresses: Samba O. Sow and Uma Onwuchekwa, Ministry of Health, Centre pour le Développement des Vaccins – Mali, Ex-Institut Marchoux, Bamako, Mali, BP251, Tel: 223-20-23-6031, Fax: 223-20-22-2883, E-mails: ssow{at}medicine.umaryland.edu and uonwuche{at}medicine.umaryland.edu. Milagritos D. Tapia, Marcela F. Pasetti, Karen L. Kotloff, and Myron M. Levine, University of Maryland School of Medicine, Center for Vaccine Development, 685 W. Baltimore St., Rm. 480, Baltimore, MD 21201, Tel: 410-706-5328, Fax: 410-706-6205, E-mails: mtapia{at}medicine.umaryland.edu, mpasetti{at}medicine.umaryland.edu, kkotloff{at}medicine.umaryland.edu, and mlevine{at}medicine.umaryland.edu. Souleymane Diallo, Mamadou Marouf Keita, and Mariam Sylla, The Clinical Bacteriology Laboratory and the Pediatric Service, Gabriel Touré Hospital, Bamako, Mali, E-mails: mmaroufkeita{at}yahoo.fr and dr_mame{at}yahoo.fr.