A Two-Center Randomized Trial of an Additional Early Dose of Measles Vaccine:Effects on Mortality and Measles Antibody Levels
| Autor: | Justin Tiendrebéogo, Osman Sankoh, Sanne Marie Thysen, Eric Nebie, Cesario Martins, Hilton Whittle, Stine Byberg, Alphonse Zakane, Olaf Müller, Peter Aaby, Amabelia Rodrigues, Ane Bærent Fisker, Moubassira Kagoné, Anja Schoeps, Fiona R. M. van der Klis, Heiko Becher, Boubacar Coulibaly, Christine Stabell Benn, Ali Sié |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Microbiology (medical) medicine.medical_specialty Randomization Measles Vaccine 030231 tropical medicine Antibodies Viral Measles child mortality law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Burkina Faso heterologous (nonspecific) effects of vaccines medicine Humans Guinea-Bissau 030212 general & internal medicine Immunization Schedule Proportional hazards model business.industry Mortality rate Hazard ratio Infant measles antibody levels medicine.disease Virology Confidence interval Infectious Diseases Measles virus measles vaccination Female Measles vaccine business |
| Zdroj: | Fisker, A B, Nebie, E, Schoeps, A, Martins, C, Rodrigues, A, Zakane, A, Kagone, M, Byberg, S, Thysen, S M, Tiendrebeogo, J, Coulibaly, B, Sankoh, O, Becher, H, Whittle, H C, van der Klis, F R M, Benn, C S, Sie, A, Müller, O & Aaby, P 2018, ' A Two-Center Randomized Trial of an Additional Early Dose of Measles Vaccine : Effects on Mortality and Measles Antibody Levels ', Clinical Infectious Diseases, vol. 66, no. 10, pp. 1573–1580 . https://doi.org/10.1093/cid/cix1033 |
| Popis: | Background In addition to protecting against measles, measles vaccine (MV) may have beneficial nonspecific effects. We tested the effect of an additional early MV on mortality and measles antibody levels. Methods Children aged 4-7 months at rural health and demographic surveillance sites in Burkina Faso and Guinea-Bissau were randomized 1:1 to an extra early standard dose of MV (Edmonston-Zagreb strain) or no extra MV 4 weeks after the third diphtheria-tetanus-pertussis-hepatitis B-Haemophilus influenzae type b vaccine. All children received routine MV at 9 months. We assessed mortality through home visits and compared mortality from enrollment to age 3 years using Cox proportional hazards models, censoring for subsequent nontrial MV. Subgroups of participants had blood sampled to assess measles antibody levels. Results Among 8309 children enrolled from 18 July 2012 to 3 December 2015, we registered 145 deaths (mortality rate: 16/1000 person-years). The mortality was lower than anticipated and did not differ by randomization group (hazard ratio, 1.05; 95% confidence interval, 0.75-1.46). At enrollment, 4% (16/447) of children in Burkina Faso and 21% (90/422) in Guinea-Bissau had protective measles antibody levels. By age 9 months, no measles-unvaccinated/-unexposed child had protective levels, while 92% (306/333) of early MV recipients had protective levels. At final follow-up, 98% (186/189) in the early MV group and 97% (196/202) in the control group had protective levels. Conclusions Early MV did not reduce all-cause mortality. Most children were susceptible to measles infection at age 4-7 months and responded with high antibody levels to early MV. Clinical trials registration NCT01644721. |
| Databáze: | OpenAIRE |
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