Hib and PBM Surveillance

Overview

Sub-Saharan Africa has one of the greatest disease burdens of Haemophilus influenzae type b (Hib), Streptococcus pneumoniae (SPN), and Neisseria meningitidis (NM) infections compared to other regions in the world, with Hib and SP infections accounting approximately 500,000 deaths per year in the region in 2000[1]. NM is additionally responsible for recurring epidemics resulting in over 700,000 cases during the last 10 years alone[2]. Introduction of new vaccines in Africa has been constrained by competing public health priorities, limited vaccine availability, inadequate funding and limited information on the disease burden associated with these infections. To gather more information about bacterial meningitis, the World Health Organization (WHO) and global immunization partners launched the Pediatric Bacterial Meningitis (PBM) Surveillance Network in the WHO African Region in 2002. The network collects data on purulent and laboratory confirmed bacterial meningitis cases among children < 5 years of age at selected sentinel hospitals sites in Africa.

The coordination and implementation of surveillance activities are conducted at the country level collaboratively by MOH and WHO staff and at the regional level by WHO/AFRO. Sentinel hospital teams include clinical, laboratory, and data management focal points. At each site, all children aged 0-59 months with an illness meeting the standardized case definition for meningitis[3] are reported as suspected cases, and cerebral spinal fluid (CSF) specimens are collected and cultured for bacterial infection.

1. Available at http://www.who.int/csr/disease/meningococcal/en/index.html
2. Burkina Faso, Burundi, Cameroun, Cote D’Ivoire, Eritrea, Gambia, Mozambique, Malawi, Mali, Namibia, Niger, Rwanda, Swaziland, Senegal, Togo, Uganda, Zambia, and Zimbabwe had one network sentinel hospital each. Ethiopia, Ghana, Kenya, Uganda and the United Republic of Tanzania had two or more sentinel hospitals participating in the PBM surveillance network.
3. A child presenting with sudden onset of fever and >=1 of the following clinical symptoms or signs of meningitis: seizures other than febrile seizures, neck stiffness, bulging fontanel (in children < 12 months), poor sucking, altered consciousness, irritability, other meningeal signs, toxic appearance, or petechial or purpuric rash.