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Early diphtheria-tetanus-pertussis vaccination associated with higher female mortality and no difference in male mortality in a cohort of low birthweight children: an observational study within a randomised trial

Archives of disease in childhood, 2012-08, Vol.97 (8), p.685-691 [Peer Reviewed Journal]

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;2015 INIST-CNRS ;Copyright: 2012 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions ;Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2012 ;ISSN: 0003-9888 ;EISSN: 1468-2044 ;DOI: 10.1136/archdischild-2011-300646 ;PMID: 22331681 ;CODEN: ADCHAK

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Title:
Early diphtheria-tetanus-pertussis vaccination associated with higher female mortality and no difference in male mortality in a cohort of low birthweight children: an observational study within a randomised trial
Author: Aaby, Peter ; Ravn, Henrik ; Roth, Adam ; Rodrigues, Amabelia ; Lisse, Ida Maria ; Diness, Birgitte Rode ; Lausch, Karen Rokkedal ; Lund, Najaaraq ; Rasmussen, Julie ; Biering-Sørensen, Sofie ; Whittle, Hilton ; Benn, Christine Stabell
Subjects: Age ; Anthropometry ; Attrition (Research Studies) ; Bacterial diseases ; BCG Vaccine - administration & dosage ; Biological and medical sciences ; Birth weight ; Birth weight, Low ; Children & youth ; Clinical Medicine ; Comparative analysis ; Desktop Publishing ; Diphtheria ; Diphtheria-Tetanus-Pertussis Vaccine - administration & dosage ; Diphtheria-Tetanus-Pertussis Vaccine - adverse effects ; Diphtheria-tetanus-pertussis vaccines ; DPT vaccine ; Drug therapy ; Ent and stomatologic bacterial diseases ; Female ; Females ; General aspects ; Guinea-Bissau - epidemiology ; Health aspects ; Human bacterial diseases ; Humans ; Hypotheses ; Immunization ; Immunization Schedule ; Infant ; Infant Mortality - trends ; Infant, Low Birth Weight ; Infant, Newborn ; Infectious diseases ; Klinisk medicin ; Low birth weight ; Low Income ; Male ; Measles ; Medical and Health Sciences ; Medical sciences ; Medicin och hälsovetenskap ; Miscellaneous ; Mortality ; Nutrition ; Nutritional Status ; Original ; Patient outcomes ; Pediatrics ; Pediatrik ; Prevention and actions ; Prognosis ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Randomized Controlled Trials as Topic ; Risk Factors ; Sex Factors ; Statistical Analysis ; Survival Analysis ; Tetanus ; Vaccination ; Vaccines ; Whooping cough
Is Part Of: Archives of disease in childhood, 2012-08, Vol.97 (8), p.685-691
Description: Background Studies from low-income countries have suggested that diphtheria-tetanus-pertussis (DTP) vaccine provided after Bacille Calmette-Guerin (BCG) vaccination may have a negative effect on female survival. The authors examined the effect of DTP in a cohort of low birthweight (LBW) infants. Methods 2320 LBW newborns were visited at 2, 6 and 12 months of age to assess nutritional and vaccination status. The authors examined survival until the 6-month visit for children who were DTP vaccinated and DTP unvaccinated at the 2-month visit. Results Two-thirds of the children had received DTP at 2 months and 50 deaths occurred between the 2-month and 6-month visits. DTP vaccinated children had a better anthropometric status for all indices than DTP unvaccinated children. Small mid-upper arm circumference (MUAC) was the strongest predictor of mortality. The death rate ratio (DRR) for DTP vaccinated versus DTP unvaccinated children differed significantly for girls (DRR 2.45; 95% CI 0.93 to 6.45) and boys (DRR 0.53; 95% CI 0.23 to 1.20) (p=0.018, homogeneity test). Adjusting for MUAC, the overall effect for DTP vaccinated children was 2.62 (95% CI 1.34 to 5.09); DRR was 5.68 (95% CI 1.83 to 17.7) for girls and 1.29 (95% CI 0.56 to 2.97) for boys (p=0.023, homogeneity test). While anthropometric indices were a strong predictor of mortality among boys, there was little or no association for girls. Conclusion Surprisingly, even though the children with the best nutritional status were vaccinated early, early DTP vaccination was associated with increased mortality for girls.
Publisher: London: BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
Language: English
Identifier: ISSN: 0003-9888
EISSN: 1468-2044
DOI: 10.1136/archdischild-2011-300646
PMID: 22331681
CODEN: ADCHAK
Source: BMJ Open Access Journals
MEDLINE
Alma/SFX Local Collection
ProQuest Central

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Early diphtheria-tetanus-pertussis vaccination associated with higher female mortality and no difference in male mortality in a cohort of low birthweight children: an observational study within a randomised trial

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