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  • Hib vaccine could save thousands in Asia

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[NEW DELHI] Vaccinating infants in Asia against a bacterium that commonly causes pneumonia and meningitis could save hundreds of thousands of lives, according to researchers.

The results of the study in Dhaka, Bangladesh, published online in the Pediatric Infectious Disease Journal last week (28 June), show that this immunisation prevents one-third of all life-threatening pneumonia cases and over 90 per cent of meningitis cases caused by Haemophilus influenzae type b (Hib).

The researchers, from the International Centre for Diarrhoeal Disease Research in Bangladesh and the US-based Johns Hopkins Bloomberg School of Public Health (JHSPH), say these results tally with previous findings from Chile and Indonesia.

They recommend the Hib vaccine for Afghanistan, Bangladesh, Bhutan, Pakistan, and Sri Lanka.

The results from the Bangladesh study ― in which 68,000 children (under the age of two) were given the Hib vaccine, along with a routine diphtheria, tetanus, and pertussis vaccine ― challenge the notion that Hib rarely causes pneumonia and meningitis in Asia, say the researchers.

But there is disagreement about the total burden of pneumonia and meningitis caused by Hib in Asia.

Jacob Puliyel, head of the paediatrics department at St Stephen's Hospital in Delhi, India, says the latest data from India, published in 2002, shows that Hib incidence is only nine per 100,000 children under five, compared to 109 per 100,000 in the West.

Puliyel told SciDev.Net that developing countries should take local disease burden and cost-effectiveness into account by when deciding on vaccination priorities.

"At the current price of $US5.60 per dose, and a regimen of three doses, it is clearly unaffordable," says Puliyel.

But Lois Privor-Dumm, director of communication strategy at JHSPH, told SciDev.Net that Bangladesh is eligible for funding for Hib vaccine from the public-private GAVI Alliance, so they will only have to pay 20 US cents per dose.

Privor-Dumm says that while it is difficult and costly to assess the true extent of disease caused by Hib, 'vaccine probe' studies such as the Bangladesh study provide a more realistic assessment of the potential to prevent disease caused by Hib. 

"Based on the availability of evidence, the World Health Organization (WHO) recommends that countries include Hib vaccine in routine infant immunisation programs, even if there is a lack of local evidence," he said.

According to the WHO, an estimated three million cases of Hib infection occur every year in children under five, resulting in approximately 400,000 deaths.

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