OBJECTIVE: To measure the disease burden and epidemiological characteristics of invasive Haemophilus influenzae in rural Mozambican children. METHODS: As part of the clinical management of children admitted to Manhiça District Hospital, blood and cerebrospinal fluid samples were collected between May 2001 and April 2005 for children aged <5 years. The level of antibiotic resistance of the isolates was analysed. RESULTS: During the surveillance period, there were 106 episodes of invasive H. influenzae disease. The estimated minimum incidence rate of invasive disease among children <5 years of age was 125/100,000 per child-year-at-risk. Fifty-six (59/106) per cent of cases were infants aged 3 to <12 months. Confirmed meningitis explained 16% of the episodes (n = 17) but was probably underestimated, as meningitis surveillance was not well implemented in the setting during the study. The case-fatality-rate was 21%, being highest among children with meningitis (odds ratio = 4.38, P = 0.011). Resistance to the antibiotics most commonly used in Mozambique was high--chloramphenicol 39%, ampicillin 35% and cotrimoxazol 74%-- and had increased over the years (P < 0.001 for chloramphenicol). CONCLUSION: Invasive H. influenzae disease is of considerable public health importance in Mozambique; implementing H. influenzae type b vaccination in sub-Saharan Africa has the potential to increase child survival.
OBJECTIVE: To measure the disease burden and epidemiological characteristics of invasive Haemophilus influenzae in rural Mozambican children. METHODS: As part of the clinical management of children admitted to Manhiça District Hospital, blood and cerebrospinal fluid samples were collected between May 2001 and April 2005 for children aged <5 years. The level of antibiotic resistance of the isolates was analysed. RESULTS: During the surveillance period, there were 106 episodes of invasive H. influenzae disease. The estimated minimum incidence rate of invasive disease among children <5 years of age was 125/100,000 per child-year-at-risk. Fifty-six (59/106) per cent of cases were infants aged 3 to <12 months. Confirmed meningitis explained 16% of the episodes (n = 17) but was probably underestimated, as meningitis surveillance was not well implemented in the setting during the study. The case-fatality-rate was 21%, being highest among children with meningitis (odds ratio = 4.38, P = 0.011). Resistance to the antibiotics most commonly used in Mozambique was high--chloramphenicol 39%, ampicillin 35% and cotrimoxazol 74%-- and had increased over the years (P < 0.001 for chloramphenicol). CONCLUSION: Invasive H. influenzae disease is of considerable public health importance in Mozambique; implementing H. influenzae type b vaccination in sub-Saharan Africa has the potential to increase child survival.
Authors: Inácio Mandomando; Betuel Sigaúque; Luis Morais; Mateu Espasa; Xavier Vallès; Jahit Sacarlal; Eusébio Macete; Pedro Aide; Llorenç Quintò; Tacilta Nhampossa; Sónia Machevo; Quique Bassat; Clara Menéndez; Joaquim Ruiz; Anna Roca; Pedro L Alonso Journal: Am J Trop Med Hyg Date: 2010-07 Impact factor: 2.345
Authors: David M P De Oliveira; Brian M Forde; Timothy J Kidd; Patrick N A Harris; Mark A Schembri; Scott A Beatson; David L Paterson; Mark J Walker Journal: Clin Microbiol Rev Date: 2020-05-13 Impact factor: 26.132