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

Samba O. Sow Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali; Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; The Clinical Bacteriology Laboratory and the Pediatric Service, Gabriel Touré Hospital, Bamako, Mali

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Milagritos D. Tapia Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali; Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; The Clinical Bacteriology Laboratory and the Pediatric Service, Gabriel Touré Hospital, Bamako, Mali

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Souleymane Diallo Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali; Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; The Clinical Bacteriology Laboratory and the Pediatric Service, Gabriel Touré Hospital, Bamako, Mali

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Mamadou Marouf Keita Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali; Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; The Clinical Bacteriology Laboratory and the Pediatric Service, Gabriel Touré Hospital, Bamako, Mali

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Mariam Sylla Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali; Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; The Clinical Bacteriology Laboratory and the Pediatric Service, Gabriel Touré Hospital, Bamako, Mali

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Uma Onwuchekwa Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali; Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; The Clinical Bacteriology Laboratory and the Pediatric Service, Gabriel Touré Hospital, Bamako, Mali

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Marcela F. Pasetti Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali; Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; The Clinical Bacteriology Laboratory and the Pediatric Service, Gabriel Touré Hospital, Bamako, Mali

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Karen L. Kotloff Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali; Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; The Clinical Bacteriology Laboratory and the Pediatric Service, Gabriel Touré Hospital, Bamako, Mali

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Myron M. Levine Centre pour le Développement des Vaccins, Mali (CVD-Mali), Bamako, Mali; Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; The Clinical Bacteriology Laboratory and the Pediatric Service, Gabriel Touré Hospital, Bamako, Mali

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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.

Author Notes

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