National Immunization Campaigns with Oral Polio Vaccine Reduce All-Cause Mortality: A Natural Experiment within Seven Randomized Trials
| Autor: | Amabelia Rodrigues, Peter Aaby, Cesario Martins, Christine Stabell Benn, Sofie Biering-Sørensen, Henrik Ravn, Andreas Andersen, Najaaraq Lund, Ane Bærent Fisker |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Pediatrics medicine.medical_specialty oral polio vaccine child mortality law.invention campaigns 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law medicine 030212 general & internal medicine MDG4 Original Research Proportional hazards model business.industry Mortality rate lcsh:Public aspects of medicine non-specific effects of vaccines Public Health Environmental and Occupational Health lcsh:RA1-1270 medicine.disease 3. Good health Poliomyelitis Discontinuation Child mortality 030104 developmental biology Number needed to treat Measles vaccine Public Health business |
| Zdroj: | Frontiers in Public Health Andersen, A, Fisker, A B, Rodrigues, A, Martins, C, Ravn, H, Lund, N, Biering-Sorensen, S, Benn, C S & Aaby, P 2018, ' National Immunization Campaigns with Oral Polio Vaccine Reduce All-Cause Mortality : A Natural Experiment within Seven Randomized Trials ', Frontiers in Public Health, vol. 6, 13 . https://doi.org/10.3389/fpubh.2018.00013 Frontiers in Public Health, Vol 6 (2018) |
| ISSN: | 2296-2565 |
| DOI: | 10.3389/fpubh.2018.00013 |
| Popis: | Background: A recent WHO review concluded that live BCG and measles vaccine (MV) may have beneficial non-specific effects (NSEs) reducing mortality from non-targeted diseases. NSEs of oral polio vaccine (OPV) were not examined. If OPV vaccination campaigns reduce the mortality rate, it would suggest beneficial NSEs.Setting: Between 2002 and 2014, Guinea-Bissau had 15 general OPV campaigns and other campaigns with OPV plus vitamin A supplementation (VAS), VAS-only, MV, and H1N1 vaccine. In this period, we conducted seven randomized controlled trials (RCTs) with mortality as main outcome.Methods: Within these RCTs, we assessed whether the mortality rate was lower after-campaign than before-campaign. We used Cox models with age as underlying time and further adjusted for low birth-weight, season and time trend in mortality. We calculated the adjusted mortality rate ratio (MRR) for after-campaign vs before-campaign.Results: The mortality rate was lower after OPV-only campaigns than before, the MRR being 0.81 (95% CI = 0.68-0.95). With each additional dose of campaign-OPV the mortality rate declined further (MRR = 0.87 (95% CI: 0.79-0.96) per dose) (test for trend, p = 0.005). No other type of campaign had similar beneficial effects. Depending on initial age and with follow-up to 3 years of age, the number needed to treat with campaign-OPV-only to save one life was between 68 and 230 children. Conclusion: Bissau had no case of polio infection so the results suggest that campaign-OPV has beneficial NSEs. Discontinuation of OPV-campaigns in low-income countries may affect general child mortality levels negatively. |
| Databáze: | OpenAIRE |
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