Baltimore, US, 09 August 2006 - The Journal of the American Medical Association (JAMA) today published research showing that, three years after introduction, routine vaccination of infants in Kenya against H. influenzae Type b (Hib) significantly reduced invasive Hib disease rates by 88%.
The paper, entitled: Effectiveness of Haemophilus influenzae Type b (Hib) Conjugate Vaccine Introduction into Routine Childhood Immunization in Kenya (1) was authored by a team led by Oxford University's Dr. Anthony Scott. According to the study (2), Hib vaccine:
- Reduced laboratory-confirmed invasive Hib disease by 88% below baseline
- Prevented an estimated 3,370 hospitalizations in Kenya in 2005
The Hib bacterium is a deadly cause of invasive disease such as meningitis and bloodstream infections, and an important cause of severe pneumonia in children under 5 years of age. Most deaths occur in the developing world, and Africa accounts for more deaths due to Hib than any other continent.
Commenting on the study, Karen Cowgill, lead author and, at the time of the study, Epidemic Intelligence Service officer at the Centers for Disease Control and Prevention in the US, said: "These results demonstrate the effectiveness of the Hib vaccine in reducing severe childhood illness and associated deaths in Kenya, and lead us to conclude that many more deaths could be averted in Africa if more countries added the vaccine to their routine immunization programs."
This is the first published study in East Africa to document the significant benefit of routine Hib vaccination in protecting young children against the devastating effects of a leading cause of childhood meningitis and pneumonia in the developing world. The findings build on a considerable body of growing evidence from Africa and around the world: similar results have been observed in The Gambia, Chile, the US, and UK. The findings contained within the study can reasonably be expected to apply to other African settings too.
Recently, a number of developing countries have begun routinely vaccinating children against Hib disease. Yet despite the overwhelming evidence and support in favor of these vaccines, less than 40% of African countries have adopted the Hib vaccine (3). One major obstacle has been the lack of available data on Hib disease burden and vaccine effectiveness.
"It is vital to support public health interventions such as the introduction of Hib vaccine with hard evidence", said Dr. Sharif, Deputy Director of Medical Services within the Ministry of Health, Kenya. "The strength of our surveillance systems will also assist us with the evaluation of new vaccines to prevent other leading child killers such as pneumococcus and rotavirus", he added.
Surveillance to monitor the impact of health and vaccination programs is essential. "Building the evidence base for the introduction of new and underused life-saving vaccines is a critical step in understanding what interventions countries need to save more lives faster", said Julian Lob-Levyt, Executive Secretary, GAVI Alliance. "If you can measure the impact a disease is having on your country, it is easier to build the case for preventing it", he added.
Worldwide, Hib disease is estimated to cause 3 million episodes of serious disease each year, leading to 400,000 childhood deaths. Where Hib vaccine has been routinely used, disease has been virtually eliminated. If countries, donors and industry can be mobilized to introduce Hib vaccine, parents, children and healthcare providers in Africa could also see death and suffering due to Hib become a concern of the past.
The GAVI Alliance, together with partners and stakeholders in Kenya and other developing countries, is working collaboratively to provide funding for vaccine programs and to implement programs to improve health systems and strengthen surveillance networks.
This study further supports the WHO's Strategic advisory Group of Experts (SAGE) and Africa's Task Force on Immunization's recommendations for global implementation of Hib vaccine and suggests that routine use could help reach the Millennium Development Goal of reducing child mortality by two-thirds by 2015.
This study was made possible through the support of Kenya Medical Research Institute, Wellcome Trust of Great Britain and the US Agency for International Development.
(1) August 9, 2006-Vol 296, No. 6 671
(2) Funding for the study was provided by the Wellcome Trust of Great Britain and the US Agency for International Development
(3) The Hib vaccine is routinely used in Kenya and 14 other countries in Africa
Notes to Editors
KEMRI-Wellcome Research Programme
Safeguarding the health of young African children is the primary motivation of research at the KEMRI-Wellcome Research Programme. With a long-standing commitment to scientific capacity strengthening, it has established itself as an internationally renowned research centre tackling malaria and other important infectious diseases such as Hib disease. The Programme is located at sites in Kilifi, an hour's drive north of Mombasa on the coast, and in the capital Nairobi. Kilifi is the major centre of clinical and epidemiological research.
Centers for Disease Control and Prevention (CDC)
CDC is the principal agency in the United States government for protecting the health and safety of all Americans. Since it was founded in 1946 to help control malaria, CDC has remained at the forefront of public health efforts to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats. Today, CDC is globally recognized for conducting research and investigations and for its action-oriented approach. CDC applies research and findings to improve people's daily lives and responds to health emergencies.
Republic of Kenya Ministry of Health (MoH)
The MoH's mission is to promote and participate in the provision of integrated and high quality preventive, curative and rehabilitative health care services to all Kenyans. The Ministry provides health services for Kenya's 32 million population. The Expanded Programme on Immunization (EPI) services in Kenya started in the early 1980s and several interventions have been carried out to boost these services. Achievements include reducing morbidity and mortality associated with vaccine-preventable diseases and ensuring services are both accessible and affordable to the community.
The Hib Initiative
Last year the GAVI Alliance launched a $37 million programme called The Hib Initiative, which unites infectious disease experts from Johns Hopkins Bloomberg School of Public Health, the London School of Hygiene and Tropical Medicine, the U.S. Centers for Disease Control and Prevention (CDC), and WHO to advance evidence-informed decision-making regarding the use of Hib vaccine in the developing world. An estimated 3 million cases of Hib disease occur each year in children under the age of 5 years, resulting in approximately 400,000 deaths.
The GAVI Alliance
An alliance of all the major stakeholders in immunization, the GAVI Alliance includes among its partners developing country and donor governments, the World Health Organization (WHO), UNICEF, the World Bank, the vaccine industry in both industrialized and developing countries, research and technical agencies, NGOs, and the Bill & Melinda Gates Foundation. It is estimated that more than 1.7 million early deaths will have been prevented as a result of support by GAVI up to the end of 2005. GAVI's efforts are critical to achieving the Millennium Development Goal on child health, which calls for reducing childhood mortality by two-thirds by 2015. Of the more than 10 million children who die before reaching their fifth birthday every year, 2.5 million die from diseases that could be prevented with currently available or new vaccines.