title: DTP with or after measles vaccination is associated with increased in-hospital mortality in Guinea-Bissau.
abstract: BACKGROUND
  The sequence of routine immunisations may be important for childhood mortality. Three doses of diphtheria-tetanus-pertussis vaccine (DTP) should be given at 6, 10, and 14 weeks and measles vaccine (MV) at 9 months of age. The sequence is not always respected. We examined in-hospital mortality of children having received DTP with or after measles vaccine.
  
  
  METHODS
  The only paediatric ward in Bissau, Guinea-Bissau.
  
  
  METHODS
  Children hospitalised during two periods in 1990-1996 and 2001-2002 who had received MV prior to hospitalisation.
  
  
  METHODS
  The all-cause case fatality at the hospital for children aged 6-17 months.
  
  
  RESULTS
  The case fatality was increased for children who had received DTP with or after measles vaccine compared with children who had received measles vaccine as the most recent vaccine, the ratio being 2.53 (1.37-4.67) and 1.77 (0.92-3.41) in the two periods, respectively. The combined estimate was 2.10 (1.34-3.28). These results were not explained by differences in nutritional status, number of doses of DTP or discharge policy.
  
  
  CONCLUSIONS
  Administration of DTP with, or after MV, may reduce the beneficial effect of MV.
authors.affiliation: Projecto de Saúde de Bandim, Apartado 861, Bissau, Guinea-Bissau. p.aaby@bandim.org
authors.forename: Peter
authors.initials: P
authors.lastname: Aaby
authors.forename: Sidu
authors.initials: S
authors.lastname: Biai
authors.forename: Jens Erik
authors.initials: JE
authors.lastname: Veirum
authors.forename: Morten
authors.initials: M
authors.lastname: Sodemann
authors.forename: Ida
authors.initials: I
authors.lastname: Lisse
authors.forename: May-Lill
authors.initials: ML
authors.lastname: Garly
authors.forename: Henrik
authors.initials: H
authors.lastname: Ravn
authors.forename: Christine Stabell
authors.initials: CS
authors.lastname: Benn
authors.forename: Amabelia
authors.initials: A
authors.lastname: Rodrigues
mesh_terms: D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000009:adverse effects*; D005260:Female; D006169:Guinea-Bissau / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D008458:Measles Vaccine / Q000009:adverse effects*; D012737:Sex Factors; D014611:Vaccination / Q000009:adverse effects*
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine; D008458:Measles Vaccine