Hib Vaccine: A Critical Ally in Asia's Effort to Reduce Child Deaths

Hib Vaccine: A Critical Ally in Asia's Effort to Reduce Child Deaths

June 28, 2007

     - New Study Shows Hib Vaccine Protects Children From
Significant 
       Burden of Life-Threatening Pneumonia and Meningitis

     - Study Shows Hib Vaccine Could Prevent About 1/3 of
Life-Threatening 
       Cases of Bacterial Pneumonia, the Leading Infectious
Cause of Death 
       in Asian Children 
     - Findings Confirm Burden of Hib Pneumonia and
Meningitis Grossly 
       Underestimated in Asia 
     - More Asian Countries now Planning Introduction of
Hib Vaccine, 
       Others Still Considering This Option 
 
    DHAKA, Bangladesh, June 28 /Xinhua-PRNewswire/ -- A new
study from Bangladesh published online today in The
Pediatric Infectious Disease Journal shows that routinely
vaccinating infants against H. influenzae type b (Hib), a
bacterium that causes deadly Hib pneumonia and meningitis,
could save hundreds of thousands of children in Asia.
Results showed that routine immunization of infants with a
Hib conjugate vaccine prevented over one-third of 
life-threatening pneumonia cases and approximately 90% of
Hib meningitis cases. A similar impact would be expected in
other parts of the region. 

    Although countries in Asia with high mortality rates
have long known that pneumonia and meningitis are a
significant concern, many assumed that Hib was not a major
cause. This vaccine study builds the evidence of the real
burden of Hib pneumonia and meningitis as has been shown in
other studies in Chile and Indonesia, that is that the
proportion of pneumonia and meningitis prevented by the Hib
conjugate vaccine is significantly higher than what can be
detected through routine surveillance. 

    "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." 

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

    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
require additional injections or visits to benefit from the
expanded protection. Bangladesh recently applied for funding
from the GAVI Alliance to introduce a DTP-Hepatitis B-Hib
"pentavalent" combination which they hope to
introduce into the routine childhood immunization program
in 2008. 

    Despite a growing body of evidence, only 26% of the
world's children live in countries with access to Hib
vaccine. This means hundreds of thousands of children in
Asian countries are currently not benefiting from this
simple, life-saving vaccine. However, Bangladesh, Pakistan,
Afghanistan, Sri Lanka and Bhutan have reviewed available
evidence and made the decision to introduce 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"
said Julian Lob-Levyt, Executive Secretary of the GAVI
Alliance. "This is a clear indication of these
governments' commitment to reduce child mortality." 

    The WHO recommends that all countries adopt Hib vaccine
into routine child immunization programs. They estimate that
Hib globally is responsible 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,"
said Dr. Kent R. Hill, Assistant Administrator, Global
Health. "Immunization programs, including Hib, are an
essential component 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. Supply studies tell us quality
manufacturers from developing countries are coming into the
market very soon and prices for this vaccine will be coming
down in the very near future. Now is the time for
additional Asian countries to make this important addition
to the EPI programs. I commend the GAVI Alliance and the
countries of Bangladesh, Pakistan, Afghanistan, Sri Lanka
and Bhutan for moving quickly to reduce needless Hib
related child deaths. 
 
    Notes to Editors 
 
    Study Facts 
 
    -- This was a case-control study in a birth cohort of
approximately 
       68,000 children aged less than two years in Dhaka. 
    -- Children were randomly assigned DTP-Hib vs. DTP
vaccine, 
    -- Cases, children confirmed as having pneumonia or
meningitis, were 
       compared with controls, children with similar
characteristics who 
       did not have these diseases 
    -- Each case was matched with four community-based
controls on age, 
       sex, season and distance; each case was also matched
with two 
       hospital controls 
    -- Vaccination status in the cases and controls was
compared, in order 
       to determine vaccine effectiveness 
    -- The study aimed to help Bangladesh to estimate the
effectiveness of 
       Hib vaccine in preventing bacterial meningitis and
X-ray confirmed 
       pneumonia 
    -- All pneumonia cases were confirmed by X-ray
according to the WHO 
       methodology; all Hib meningitis and probable
bacterial meningitis 
       were confirmed by laboratory tests 
    -- The preventable fraction of X-ray confirmed
pneumonia using 
       community and hospital controls respectively, was
34% and 44% 
    -- The preventable fraction of confirmed Hib meningitis
using community 
       and hospital controls was 89% and 93% respectively 
    -- The protocol was reviewed and approved by ICDDR, B
and Dhaka Shishu 
       Hospitals' Research and Ethics Committees. 
    -- The study was funded by the Urban Primary Health
Care Project 
        (UPHCP) of the Government of Bangladesh, Asian
Development Bank, 
       the United States Agency for International
Development (USAID) and 
       the National Vaccine Program Office (NVPO) of the
USA. Technical 
       assistance was provided by WHO. 
 
    Hib Pneumonia and Hib Meningitis 
    The Hib bacterium is the leading cause of meningitis in
children and one of two major causes of severe childhood
bacterial pneumonia. Pneumonia and meningitis caused by
other bacteria such as pneumococcus and meningococcus
(which causes meningitis only) will not be prevented by Hib
vaccine, but vaccines for these diseases will be available
in the near future. 
 



    For further information on the study partners, Hib
pneumonia and meningitis or to arrange an interview with an
expert, please contact: 

     Dr. Serguei Diorditsa
     Medical Officer 
     Immunization and Vaccine Development
     World Health Organization Bangladesh
     Office:  [phone]
     Email:   [e-mail]

     Lois Privor-Dumm, MIBS
     Director, Communications Strategy
     The Hib Initiative
     Mobile:  [phone]
     Email:   [e-mail]
     Website: www.hibaction.org

     Ruth Landy
     Senior Programme Officer, Advocacy &
     Communications
     The GAVI Alliance
     Mobile:  [phone]
     Email:   [e-mail]
     Website: www.gavialliance.org
 
     Georgina Pinnington
     Ruder Finn Communications
     Office:  [phone]
     Email:   [e-mail]