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Routine Hib Vaccination Could Save Innumerable Asian Children

A new study has shown that regular vaccination of infants against H. influenzae type b (Hib), a bacterium that causes deadly Hib pneumonia and meningitis, could save innumerable children in Asia.

The study from Bangladesh, which is published online in The Pediatric Infectious Disease Journal, has established that routine immunization of infants with a Hib conjugate vaccine prevented more than one-third of acute pneumonia cases and approximately 90 percent of Hib meningitis cases. The researchers said that similar impact would be expected in other parts of the region.

This vaccine study puts together the evidence of the actual burden of Hib pneumonia and meningitis as has been shown in other studies in Chile and Indonesia, that is that the percentage of pneumonia and meningitis prevented by the Hib conjugate vaccine is considerably higher than what can be detected through routine observation.

"There has been an ongoing disagreement about the total burden of Hib pneumonia and meningitis in Asia, but our findings provide evidence challenging the commonly held notion that these diseases are rare in Asia," said Dr Abdullah Baqui, Associate Professor, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.

"Our research shows that routine Hib vaccination is a feasible and highly effective way of preventing death related to Hib pneumonia and meningitis and could save the lives of a significant number of Asian children who die under the age of five," he added.

The study was conducted by researchers from International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka Shishu Hospital and John Hopkins University. The vaccine used in the study replaced the routine diphtheria, tetanus and pertussis (DTP) vaccine with a DTP-Hib combination. The combination vaccine did not call for supplementary injections or visits to benefit from the expanded protection. Bangladesh recently app lied for funding from the GAVI Alliance to set up a DTP-Hepatitis B-Hib "pentavalent" combination which they hope to introduce into the routine childhood immunization program in 2008.

"Bangladesh views Hib vaccine as an integral tool in our mission to improve child survival in Bangladesh. This study supported the conclusions of the consultative workshop organized in June 2006 by WHO around the introduction of the Hib vaccine into Bangladesh," said Dr. Md. Abdul Quader Mian, Deputy Director EPI and Programme Manager Child Health and LCC, Ministry of Health, Bangladesh.

In spite of a growing body of evidence, only 26 percent of the world's children live in countries with access to Hib vaccine. This means hundreds of thousands of children in Asian countries are presently not benefiting from this easy, life-saving vaccine. However, Bangladesh, Pakistan, Afghanistan, Sri Lanka and Bhutan have reviewed existing evidence and made the decision to bring in Hib vaccine and applied for support from the GAVI Alliance.

"We are delighted that so many Asian countries are preparing to introduce the Hib vaccine and protect their children against Hib pneumonia and Hib meningitis. This is a clear indication of these governments' commitment to reduce child mortality," said Julian Lob-Levyt, Executive Secretary of the GAVI Alliance.

The WHO recommends that all countries implement Hib vaccine into routine child immunization programs. They assess that Hib internationally is to blame for 400,000 deaths each year in children under five years of age and around 3 million cases of serious illness resulting in long term consequences such as deafness, learning disabilities, paralysis and mental retardation.

"This simple, life-saving vaccine can prevent Hib pneumonia and meningitis in children, often called the 'invisible cause of forgotten child killers' in Asia. Immunization programs, including Hib, are an essential com ponent of USAID's strategy to prevent life-threatening childhood infections. These data are clear - Hib vaccine is an important addition to immunization programs through out Asia," said Dr. Kent R. Hill, Assistant Administrator, Global Health.


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