The Gambia was the first African country to introduce routine immunisation with conjugate Haemophilus influenzae type b (Hib) vaccine in 1997 which resulted in the virtual elimination of Hib disease in 2002. Continued Hib disease surveillance showed a low level of incidence of Hib disease which continued until 2010.
From 2011 to 2013, 24 cases of invasive Hib disease were detected from eastern Gambia where invasive bacterial disease surveillance began in 2008 with the introduction of pneumococcal conjugate vaccine. This was accompanied by several incidentally detected hospital cases in the Western Region. The recent resurgence accompanied by evidence of waning immunity in older children in a fully vaccinated population reinforces the need for continuing surveillance and raises the question of the need for a booster dose in this country.

“Strengthening surveillance and associated research of invasive Haemophilus influenzae type b (Hib) infection in The Gambia to understand its evolving epidemiology (Hib Surveillance)” is the title of the ongoing study led by lead by Dr Akram Zaman, Senior Clinical Scientist which aims to enhance Hib meningitis surveillance efforts in Western Region (WR), measure incidence of Hib disease, identify any emerging hyper-invasive clones of Hib, and to detect potential reservoirs for increased transmission by undertaking carriage studies. Enhanced Hib meningitis surveillance has been re-established at all Major Health Centres and Hospitals in the Western Region that treat suspected meningitis cases. The same definitions and methods as used in the previous surveillance from 2007-2010 are being followed for assessment of temporal trends in incidence.

The handing over ceremony
A team from MRC lead by Dr Akram Zaman, handed over two motorcycles to the Ministry of Health and Social Welfare (MOHSW) on the 9th June 2015. These motorcycles will be used for the Hib surveillance project which is a  public health work done together with the MOHSW, Regional Health Teams, Major Health Centres, and hospitals to enhance the Hib meningitis surveillance efforts in the Western Region (WR). Dr Akram Zaman thanked Dr Samba Ceesay, Director of Health Services for accepting two motorcycles from MRC and for his continued interest and support in the project. He also thanked Dr Ceesay for inaugurating the  training workshop for all clinicians and laboratory scientist involved in the project that was offered seven months ago. Ignitious Baldeh,  Director of The National Public Health Laboratories  (NPHL) and Regional Health Teams were also thanked for their impeccable contributions to the project.

Mr Ignatius Baldeh said “Serekunda and Brikama Health Centres will be directly benefitting from this gesture which will facilitate more efficient sample collection for Western Region 1 and Western Region 2.” He further added that the samples collected from health facilities will be analysed by NPHL and compared with the results of the same samples processed by MRC for quality assurance purposes. Mr Baldeh concluded by thanking MRC for strengthening the NPHL and setting the standards for the quality involved in data collection for the project. Other health facilities that have also been included in Hib surveillance are Edward Francis Small Teaching Hospital, MRC Ward, Serekunda General Hospital, Jammeh Foundation for Peace Hospital, Fajikunda Health Centre, Sibanor WEC Mission Hospital, and Sulayman Junkung General (Bwiam) Hospital.

Riders for health Deputy Director, Mr Omar N Jah also applauded the gesture and  thanked the MRC, “As we are the custodian for the training of motocycle riders, repairs and maintenance, the two motorcycles will elevate the prompt service delivery of sample collection” he said.

The Director of health services Dr Samba Ceesay thanked MRC for the longstanding support and collaboration. “The Gambia has been benefiting a lot from the MRC, the motorcycles will go a long way in complementing government efforts to provide quality and timely services for sample collection for the surveillance.”