MRC study finds vaccine eliminates HIB disease in the Gambia

A Medical Research Council (MRC) study results, announced online today in The Lancet, illustrate that a routine immunisation programme in The Gambia has been successful at eliminating the incidence of Haemophilus influenzae type b (Hib) disease.

Hib disease has been shown to be an important cause of childhood meningitis and a major cause of bacterial pneumonia in children. Hib is estimated to cause at least 3 million cases of serious disease and hundreds of thousands of deaths annually, worldwide. The Gambian Expanded Programme for Immunisation (EPI) was one of the first programmes in Africa to introduce routine Hib vaccination, giving children three doses of the vaccine at two, three and four months old.

During a five-year surveillance study, the MRC research team monitored the use of Hib vaccination in the Western Region of The Gambia, where 60% of the total population live. The team looked at the vaccine's effect on Hib disease from the start of routine use of the vaccine in May 1997 until April 2002.

Their observations illustrated that after the introduction of routine Hib immunization, the annual incidence rate of meningitis in infants in The Gambia dropped sharply from over 200 per 100,000 to 21 per 100,000 in the first two years of vaccination. The incidence then declined further to 0 per 100,000 in the fifth year after the introduction of routine immunisation.

Dr. Richard Adegbola of the MRC led the study. He said: "Hib disease has been eliminated in developed countries for two decades, but many developing countries are still reluctant to introduce routine vaccination due to the lack of available information on how effective it is, especially when vaccine supplies might be erratic.

"Our study shows that despite an erratic vaccine supply, elimination of Hib disease is possible. We hope other countries in sub-Saharan Africa will now be encouraged to also adopt routine Hib vaccination programmes."

Financial support for the study was received from WHO. Sanofi Pasteur donated the Hib vaccines to The Gambian government for the five year period.