Table 3. Estimated burden of disease for Haemophilus influenzae type b (Hib) meningitis and pneumonia among children 0–59 months, before and 4 years after Hib conjugate vaccine introduction, Uganda, 2001–2006.
| Pre-vaccine year | Fourth year of vaccination | Data source | |
|---|---|---|---|
| MENINGITIS | |||
| Hospitalized meningitis | |||
| Confirmed hospitalized Hib incidencea | 33 | 1.8 | Study |
| Purulent meningitis of unknown cause | |||
| Confirmed incidencea | 62 | 16 | Study |
| Vaccine effectiveness (%, for 2+ doses) | 53 | 53 | Study |
| Estimated Hib incidencea among etiology-negative purulent cases (confirmed incidence x VE) | 33 | 8.5 | Calculated |
| Total hospitalized Hib incidencea (confirmed + estimated)a | 66 | 10 | Calculated |
| Case fatality ratio (%) | 20 | 11 | Study |
| Fatal H. influenzae meningitis incidencea (total hospitalized x CFR) | 13 | 1.1 | Calculated |
| Non-hospitalized meningitis | |||
| Proportion of meningitis cases not presenting to hospital (%) | 33 | 33 | 19 |
| Estimated non-hospitalized Hib incidencea (total hospitalized x % not presenting to hospital) | 22 | 3.4 | Calculated |
| CFR (%) | 90 | 90 | Assumption |
| Fatal H. influenzae meningitis incidencea (total non-hospitalized x CFR) | 20 | 3.1 | Calculated |
| Neurologic sequelae among survivors | |||
| Proportion (%) | 34 | 34 | 20 |
| Incidencea of neurologic sequelae | 19 | 3.2 | Calculated |
| PNEUMONIA | |||
| Ratio of Hib meningitis to Hib pneumonia | 5 | 5 | 3 |
| Hospitalized Hib pneumonia incidencea (hospitalized meningitis incidence x 5) | 351 | 52 | Calculated |
| Non-hospitalized Hib pneumonia incidencea (non-hospitalized meningitis incidence x 5) | 109 | 17 | Calculated |
| Hospitalized case fatality ratio (%) | 10 | 10 | 21 |
| Hospitalized fatal Hib pneumonia incidencea (hospitalized Hib pneumonia incidence x CFR) | 33 | 5.2 | Calculated |
| Non-hospitalized case fatality ratio (%) | 30 | 30 | 21 |
| Non-hospitalized fatal Hib pneumonia incidencea (non-hospitalized Hib pneumonia incidence x CFR) | 33 | 5.1 | Calculated |
| SUMMARY | |||
| Total Hib pneumonia and meningitis incidencea | 528 | 82 | Calculated |
| Total fatal Hib pneumonia and meningitis incidencea | 99 | 14 | Calculated |
| BURDEN OF VACCINE-PREVENTABLE HIB DISEASE 2007 | |||
|
Without Hib vaccineb |
|||
| Uganda population < 5 years of age in 2007 | 5 300 000 | Calculated13 | |
| Children with Hib meningitis, cases per year | 4 662 | Calculated | |
| Children with Hib pneumonia, cases per year | 23 310 | Calculated | |
| Child deaths due to Hib per year | 5 230 | Calculated | |
| Children with severe Hib-related neurologic sequelae per year | 989 | Calculated | |
CFR, case-fatality ratio; Hib, Haemophilus influenzae type b; VE, vaccine effectiveness. a Incidence or fatal incidence: cases or deaths per 100 000 children < 5 years of age per year. b Pre-vaccine incidence applied to 2007 population.