Effet Immédiat du Vaccin Anti H. Influenzae sur les Méningites Bactériennes de l’Enfant à Yaoundé

Félicitée Nguefack, Paul Koki Ndombo, Ali Falmata Moundou, Marie Kobela, Francisca Monebenimp, Evelyn Mah, Angeline Boula, Marie Thérèse Obama Abena

Abstract


RÉSUMÉ
Introduction. Le vaccin anti-Haemophilus a entrainé une baisse sensible des infections sévères dues à cette bactérie dans les pays du Nord. Dans le contexte camerounais, marqué notamment par une prévalence élevée de la malnutrition, source d’une baisse de l’immunité, notre étude s’est proposée d’examiner l’effet de cette vaccination dans la communauté. Objectif. D’écrire l’épidémiologie des méningites pédiatriques après l’introduction de ce vaccin. Méthode. Étude rétrospective examinant le profil bactériologique des méningites purulentes avec en miroir le statut vaccinal des patients. Ce faisant, elle a comparé les patients reçus pendant (2008) et à ceux admis après (2009) la période d’introduction du vaccin. Résultats. 230 dossiers médicaux ont été examinés ; soit 134 en 2008 et 96 en 2009. L’âge des patients variait entre 2-59 mois ; 63,5% et 68,8% étaient âgés de 2-12 mois en 2008 et 2009 respectivement. H. influenzae prédominait (47,0% des souches isolées) en 2008 et majoritairement (63,5%) chez les patients âgés de moins 12 mois. Ensuite venait S. pneumoniae (33,6%), retrouvé chez 31,1% et 68,9% des patients de moins de 12 mois et de 13-59 mois respectivement. En 2009, H. influenzae B n’était plus noté que chez 33,3% des patients; une proportion bien en deçà des chiffres de l’incidence relative du pneumocoque dans la même période (44,8%). La couverture vaccinale était faible; seuls 19,4% des patients avaient reçu au moins une dose du vaccin anti-Haemophilus en 2008 et 45,8% en 2009. Conclusion. L’effet immédiat (dans l’intervalle d’un an) du vaccin anti-Haemophilus était perceptible sur l’incidence hospitalière des méningites pédiatriques.

ABSTRACT
Introduction. Vaccination against Haemophilus has caused significant drop in severe infections caused by these bacteria in the Northern countries. In the Cameroonian context marked by the high prevalence of malnutrition in children, resulting in the drop in their immunity, our study is aimed at examining the effect of the anti-Haemophilus vaccination in the community. Objective. To describe the epidemiology of pediatric meningitis, after the introduction of this vaccine. Method. A retrospective study examining the bacteriologic profile of purulent meningitis with regard of the vaccination status of patients. Patients admitted during the period of introduction of the vaccine (2008) were compared to those admitted after (2009). Results. A total of 230 medical files were examined. There were 134 patients in 2008 and 96 in 2009. Most of them were aged 2-59 months (63.5%) and 2-12 months (68.8%) in 2008 and 2009 respectively. H. influenzae b was predominant (47.0% of the isolated stains) in 2008 and mostly in patients aged < 12 months (63.5%). This was followed by S. pneumoniae (33.6%), found in 31.1% and 68.9% of patients less than 12 months and 13-59 months respectively. In 2009, H. influenzae b was only found in 33.3% patients, far below the relative incidence of pneumococcus (44.8%) in the same period. The vaccination coverage was low; only 19.4% of patients had received at least one dose of the anti-Haemophilus vaccine in 2008 and 45.8% in 2009. Conclusion. The immediate effect (within an interval of one year) of the anti-Haemophilus vaccine was perceptible on the hospital incidence of pediatric meningitis.


Keywords


Méningites, H. influenzae, vaccin, enfant, épidémiologie.

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References


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