THE PREVALENCE OF HAEMOPHILUS INFLUENZAE TYPE B COLONIZATION IN
CHILDREN IN TURKEY
Akcakaya N1; Camcioglu Y1;
Belbek S1; Eskazan G2; Cokugras H2
1 Division of Infectious
Disease, Clinical Immunology and Allergy, Department of Pediatrics,
Istanbul, Turkey
2 Cerrahpasa Medical Faculty
Day Care Center, Cerrahpasa Medical Faculty, Istanbul, Turkey
Objectives: To
assess the effect of group settings on the prevalence of pharngeal
colonization with Haemophilus influenzae type b (Hib) among children who
were parental home care before attending a hospital based day-care center
(DCC) and after enrolled care center for at least three months. The second
question was, do parents who worked in the health care settings may
increase the rate of Hib colonization by transmitting that agent to their
children.
Methods:
The DCC of Cerrahpasa Medical Faculty (CMF) was
chosen to recruit children. This day care center was a hospital-based DCC
and attendees were preschool children. To clarify the impact of close
contact with medical employers to carriage rate, children of non-medical
families of Bahcelievler-DCC were selected from a different region of
Istanbul were chosen as a control group. Three groups were formed. In the
first group (I) there were 50 attended CMF-DCC for at least 3 months, twice
nasopharyngeal culture specimens were obtained, at enrollment and 3 months
later. In the second group(II) there were 103 children from CMF-DCC, in the
third group there were 40 children was composed of from Bahcelievler-DCC
who had been at the center for 6 months. Nasopharyngeal culture specimens
were obtained once in both groups. 243 nasopharyngeal culture specimens
were obtained by thorough swabbing of the posterior pharynx, between
September 1996 and March 1997. These children were not vaccinated for
Haemophilus influenzae type b (Hib) since Hib vaccine is not applied
routinely in Turkey.
Results:
The incidence of Hib carrier state at enrollment was
4 % which raised significantly to 22 % 3 months later in the first Group
(I). In contrast to group I, Hib was identified in 40.7% and 47.5% of
healthy children, who spent more than 6 months at CMF-DCC(group II) and
Bahcelievler-DCC(group III) respectively. No significant differences was
observed between carriage rates of children coming from medical and
non-medical families and the avarege carriage rate was 42.6% when the
duration of day care attendance exceeded six months.
Conclusion:
Hib carriage rate was affected by the duration of day
care attendance presumably through increased transmission but not daily
contact with medical staff.