Population-based surveillance for bacterial meningitis in the Dominican Republic: implications for control by vaccination

Quantifying the local burden of disease is an important step towards the in troduction of new vaccines, such as Haemophilus influenzae type b (Hib) con jugate vaccine. We adapted a generic protocol developed by the World Health Organization for population-based surveillance of bacterial meningitis. Al l hospitals that admit paediatric patients with meningitis in the National District, Dominican Republic were included in the system and standard labor atory methods were used. The system identified 111 cases of confirmed bacte rial meningitis. Hib was the leading cause of bacterial meningitis, followe d by group B streptococcus, S. pneumoniae, and N. meningitidis. Unlike hosp ital-based case series, this population-based system was able to calculate incidence rates. The incidence of Hib meningitis was 13 cases per 100 000 c hildren < 5 years old. The data from this study were used by the Ministry o f Health to support the introduction of routine Hib vaccination and will be used to monitor its effectiveness.