Pediatric disease burden and vaccination recommendations: understanding local differences

Angela Gentile, Zulfiqar Bhutta, Lulu Bravo, Aly Gamal Samy, R. Dennis J. Garcia, Anwar Hoosen, Tazul Islam, Abdollah Karimi, Mona Salem, Sriluck Simasathien, Amir Sohail, Veerachai Watanaveeradej, Karin Wiedenmayer, Heinz J. Schmitt

Research output: Contribution to journalReview articlepeer-review

28 Citations (Scopus)


Background: Diphtheria (D), tetanus (T), pertussis (P), hepatitis B (HepB), invasive Haemophilus influenzae type b (Hib) disease, and measles cause substantial global morbidity and mortality. Methods: This unique review highlights geographic differences in disease burden across certain countries in the African, Americas, Mediterranean, South-East Asian, and Western Pacific World Health Organization (WHO) regions, and relates this to vaccination coverage and local vaccine recommendations using the authors' countries as illustrations. Results: Substantial differences were observed in the incidence of these diseases and in vaccination coverage between the countries studied. Disease incidence often reflected inadequate surveillance, but also variable or poor vaccination coverage. Vaccination coverage against HepB was particularly low in the African and South-East Asian WHO regions; vaccination coverage against invasive Hib disease was low in these regions and in the Eastern Mediterranean and Western Pacific WHO regions. Vaccination schedules within some countries in these regions do not include, or have only recently included, vaccinations against HepB and Hib disease. The use of DTwP-HepB-Hib (diphtheria, tetanus, whole-cell pertussis, HepB, Hib) combination vaccines has now been adopted by some countries to help increase vaccination coverage. Conclusions: Vaccination coverage and vaccination schedules vary markedly between the countries studied, often according to the resources available. DTwP-HepB-Hib combination vaccines represent a cost-effective option, with the potential to substantially reduce the burden associated with these diseases by increasing coverage and compliance.

Original languageEnglish
Pages (from-to)e649-e658
JournalInternational Journal of Infectious Diseases
Issue number8
Publication statusPublished - Aug 2010


  • Diphtheria
  • Haemophilus influenzae type b
  • Hepatitis B
  • Measles
  • Pertussis
  • Tetanus


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