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A rare encounter with acute epiglottitis

Lok FYL, Chan PWK, Goh AYT

JUMMEC, 2001;6:34-35.

We describe a rare encounte.r with a 6-year old Indian boy admitted with acute epiglottitis due to Haemophilus influenzae. Acute epiglottitis is an uncommon cause of lifethreatening upper airway obstruction and a rare presentation of invasive Haemophilus influenzae type b (Hib) disease in this region, compared to Ihe more developed West. The cause for this observation is often attributed to differences in the genetic predisposition and socio-economk parameters. The organism subtype and the host response have been shown to determine the type of invasive Hib disease. However, the evidence to explain this difference is poorly understood and remains an intriguing enigma. KEYWORDS: Epiglottitis, Haemophilus influenzae

Matched MeSH terms: Haemophilus influenzae type b
Carriage of Haemophilus influenzae among children attending childcare centres in Kuala Lumpur, Malaysia in the post vaccination era: A cross-sectional study

Palaniappan PA, Mohamed Sukur S, Liow YL, Maniam S, Sherina F, Ahmad N

Vaccine, 2020 12 03;38(51):8232-8237.
PMID: 33139134 DOI: 10.1016/j.vaccine.2020.09.066

BACKGROUND: Haemophilus influenzae (H. influenzae) is a human upper respiratory tract colonizer which causes wide range of disease especially in children<5 years old and in the elderly. Although worldwide incidence in industrialised countries where Hib vaccination is commonly used has dropped sharply since implementation of H. influenzae type b (Hib) vaccination, there is limited data on the disease burden caused by H. influenzae in Malaysia post vaccination era. A change in predominant serotype from type b to non-b serotypes of H. influenzae in invasive diseases was reported worldwide. We investigated the carriage of H. influenzae post vaccination era among 2-4 years old.
METHODOLOGY: Randomly, we collected 436 oropharyngeal swabs from healthy children aged 2-4 years in 30 registered childcare centres in Kuala Lumpur (August 2018-May 2019). Informed consent and written questionnaires were obtained from parents. H. influenzae was identified by standard microbiological methods. Univariable analysis was carried out to describe variables associated with colonization. All variables with p type a (9; 37.5%), type b (5; 20.8%), type c (3; 12.5%), type d (2; 8%), type e (1; 4.2%) and type f (4; 16.7%). Variables like age, basic sanitation, immunization status, body mass index were included in multivariable logistic regression test since p values in univariate analysis were<0.25. Planned sewage system was found to be significant (Adjusted OR, 0.06; 95% CI, 0.01-0.46; p = 0.006).
CONCLUSION: Fewer carriage rates were observed among children post Hib vaccination era. Hib carriage is still possible after vaccination. The presence non-b serotypes may imply emerging replacement serotypes.

Matched MeSH terms: Haemophilus influenzae type b*
Haemophilus influenzae meningitis in Malaysia

Hussain IH, Sofiah A, Ong LC, Choo KE, Musa MN, Teh KH, et al.

Pediatr Infect Dis J, 1998 Sep;17(9 Suppl):S189-90.
PMID: 9781759

To determine the pattern of postneonatal childhood meningitis in Malaysia.

Matched MeSH terms: Haemophilus influenzae type b
A 2-year prospective study on childhood acute bacterial meningitis in Tengku Ampuan Afzan Hospital, Kuantan, Pahang

Wahab, J.A., Fadzil, A.A., Zainab, K., Affendi, A.M., Naznin, M.

Malaysian Journal of Paediatrics and Child Health, 2000;12(1):48-54.
MyJurnal

During a 24-month period, 21 children with acute bacterial meningitis were identified and studied. The majority of the children was from low socio-economic group and the male:female sex ratio was equal. Seventeen children (81%) were aged twelve months or below. In 15 (71.5%) of the children. Haemophilus influenzae type b was recovered, while Streptococcus pneumoniae was isolated from 4 children. Neisseria spp and Salmonella spp were identified respectively in each of the other two cases. The case fatality was four (19.0%) with nine others (42%) exhibiting neurological sequelae. Except for the Salmonella spp strain that was resistant to the cephalosporin, the rest of the bacterial species were sensitive to the commonly used antibiotics. As Haemophilus influenzae type b is still the most prevalent cause of acute bacterial meningitis, it is therefore strongly recommended that the national immunisation programme in this country should include the vaccine for it in our effort to minimise the mortality and morbidity caused by this organism.

Matched MeSH terms: Haemophilus influenzae type b
Fulltext Factors influencing childhood immunization defaulters in Sabah, Malaysia

Shamsul Azhar, S., Rohaizat, H., Azimatun Noor, A., Rozita, H., Nazarudin, S., Nirmal, K.

International Medical Journal Malaysia, 2012;11(1):17-22.
MyJurnal

Introduction: The purpose of this study was to determine the prevalence of defaulters of immunization, and their associated risk factors among children age 12 to 24 months. Materials and Methods: A cross-sectional study was conducted in all government's maternal child health clinics in District of Kota Kinabalu, Sabah. Data was collected using a standardised questionnaire from July to November 2006. Results: The prevalence rate for defaulting immunization was 16.8% from the 315 respondents. Bivariable analysis showed various significant factors associated with defaulters such as mother’s employment status, family mobility, transportation and cost. Nonetheless, multivariable analysis showed only mother’s age, mother employment status and family size were the significant predictors for defaulting immunization. Immunization that had the highest rate of defaulters was DPT–OPV booster dose (56.6%), followed by MMR immunization (43.4 %) and
DPT-Hib/OPV and Hep B third dose (37.7%).Conclusion: Employed mothers with bigger family size should be more closely monitored and advised to reduce the chance of defaulting on the immunization. Health promotion activities also should focus to these groups of mothers.

Matched MeSH terms: Haemophilus influenzae type b
Fulltext Economic Evaluation and Budget Impact Analysis of Vaccination against Haemophilus influenzae Type b Infection in Thailand

Kotirum S, Muangchana C, Techathawat S, Dilokthornsakul P, Wu DB, Chaiyakunapruk N

Front Public Health, 2017;5:289.
PMID: 29209602 DOI: 10.3389/fpubh.2017.00289

Current study aimed to estimate clinical and economic outcomes of providing the Haemophilus influenzae type b (Hib) vaccination as a national vaccine immunization program in Thailand. A decision tree combined with Markov model was developed to simulate relevant costs and health outcomes covering lifetime horizon in societal and health care payer perspectives. This analysis considered children aged under 5 years old whom preventive vaccine of Hib infection are indicated. Two combined Hib vaccination schedules were considered: three-dose series (3 + 0) and three-dose series plus a booster does (3 + 1) compared with no vaccination. Budget impact analysis was also performed under Thai government perspective. The outcomes were reported as Hib-infected cases averted and incremental cost-effectiveness ratios (ICERs) in 2014 Thai baht (THB) ($) per quality-adjusted life year (QALY) gained. In base-case scenario, the model estimates that 3,960 infected cases, 59 disability cases, and 97 deaths can be prevented by national Hib vaccination program. The ICER for 3 + 0 schedule was THB 1,099 ($34) per QALY gained under societal perspective. The model was sensitive to pneumonia incidence among aged under 5 years old and direct non-medical care cost per episode of Hib pneumonia. Hib vaccination is very cost-effective in the Thai context. The budget impact analysis showed that Thai government needed to invest an additional budget of 110 ($3.4) million to implement Hib vaccination program. Policy makers should consider our findings for adopting this vaccine into national immunization program.

Matched MeSH terms: Haemophilus influenzae type b
Vaccine preventable meningitis in Malaysia: epidemiology and management

McNeil HC, Jefferies JM, Clarke SC

Expert Rev Anti Infect Ther, 2015 06;13(6):705-14.
PMID: 25962101 DOI: 10.1586/14787210.2015.1033401

Worldwide bacterial meningitis accounts for more than one million cases and 135,000 deaths annually. Profound, lasting neurological complications occur in 9-25% of cases. This review confirms the greatest risk from bacterial meningitis is in early life in Malaysia. Much of the disease burden can be avoided by immunization, particularly against Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae. Despite inclusion of the Hib vaccine in the National Immunisation Programme and the licensure of pneumococcal vaccines, these two species are the main contributors to bacterial meningitis in Malaysia, with Neisseria meningitidis and Mycobacterium tuberculosis, causing a smaller proportion of disease. The high Hib prevalence may partly be due to dated, small-scale studies limiting the understanding of the current epidemiological situation. This highlights the need for larger, better quality surveillance from Malaysia to evaluate the success of Hib immunization and to help guide immunization policy for vaccines against S. pneumoniae and N. meningitidis.

Matched MeSH terms: Haemophilus influenzae type b