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Epidemiology of Haemophilus influenzae invasive disease in Jamaica, 1990-1993
M A Barton-Forbes1, M Samms-Vaughan, B Irons
1Department of Obstetrics and Gynaecology and Child Health, University of the West Indies, Kingston, Jamaica. m2forbes@cwjamaica.com
Insights
Invasive Haemophilus influenzae disease disproportionately affects young Jamaican children, with meningitis being the most common diagnosis. Antibiotic resistance and seasonal patterns highlight the need for vaccine prophylaxis.
Area of Science:
- Pediatric Infectious Diseases
- Epidemiology
- Microbiology
Background:
- Haemophilus influenzae (H influenzae) invasive disease poses a significant threat to young children globally.
- Understanding local epidemiological patterns is crucial for effective disease management and prevention strategies.
Purpose of the Study:
- To retrospectively analyze the incidence, clinical features, and antimicrobial resistance patterns of invasive H influenzae disease in children admitted to Bustamante Hospital for Children, Kingston, Jamaica.
- To inform empiric antibiotic therapy guidelines and evaluate the potential impact of vaccine prophylaxis.
Main Methods:
- Retrospective review of 86 cases of invasive H influenzae disease in children over a four-year period.
- Analysis of patient demographics, clinical diagnoses, seasonal distribution, treatment outcomes, and antimicrobial susceptibility testing of H influenzae isolates.
Main Results:
- The estimated annual incidence was 39 per 100,000 children under 5 years. The majority of cases (77%) occurred in children under 2 years.
- Meningitis was the most frequent diagnosis (76%), with a poor outcome in 21.5% of meningitis cases. A seasonal peak was observed during cooler months (57-73%).
- Antimicrobial resistance rates were 26% for ampicillin and 7% for chloramphenicol.
Conclusions:
- Invasive H influenzae disease is a significant pediatric concern in Jamaica, particularly in infants and young children.
- The observed antibiotic resistance patterns and seasonal trends necessitate careful consideration for empiric antibiotic treatment.
- The findings strongly support the implementation of H influenzae vaccine prophylaxis for Jamaican children to reduce disease burden.
Abstract:
Haemophilus influenzae (H influenzae) invasive disease was studied retrospectively over a four-year period in children admitted to the Bustamante Hospital for Children in Kingston, Jamaica. A total of 86 cases were identified. The mean estimated annual incidence of H influenzae invasive disease in Kingston and St Andrew was 39 per 100,000 children under 5 years of age. The majority (77%) of cases were in the under 2-year age group. A distinct seasonal pattern was noted, with a significantly higher proportion of patients (57-73%) presenting in the cooler months. Meningitis was the most common clinical diagnosis, accounting for 76% of the cases. Poor outcome was demonstrated in 21.5% of patients with meningitis. Sensitivity testing of H influenzae isolates revealed a resistance rate of 26% for ampicillin and 7% for chloramphenicol. The epidemiological findings in this study provide reasonable guidelines for empiric antibiotic therapy and also support the need to seriously consider vaccine prophylaxis in Jamaican children.