THE INCREASING BURDEN OF DISEASE IN BANGLADESHI CHILDREN DUE TO HAEMOPHILUS-INFLUENZAE TYPE-B MENINGITIS

A laboratory-based study of diagnosed bacterial meningitis in the nati onal paediatric hospital identified 852 cases of meningitis in the 8-y ear period 1987-1994. There were 587 culture-positive cases, of which Haemophilus influenzae (47%) and Streptococcus pneumoniae (32%) accoun ted for 80%. H. influenzas showed a remarkable increase of 700% during the study period. Most of the H. influenzae cases (90%) occurred in t he 1st 2 years of life. Analysis of culture-negative specimens by anti gen detection in the last 2 years also revealed the predominance of H. influenzae (71.4%) and S. pneumoniae (22.4%). Typing of H. influenzae isolates during this time showed that 98% of the strains were type b. This retrospective hospital-based study indicated a pronounced increa se in the incidence of H. influenzae meningitis and strongly supports the need for large-scale Hib vaccination for young children. However, such nationwide intervention will probably need to be based on a prosp ective and population-based surveillance of H. influenzae infections.