DTP with or after measles vaccination is associated with increased in-hospital mortality in Guinea-Bissau.
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.
Aaby
Peter
P
Projecto de Saúde de Bandim, Apartado 861, Bissau, Guinea-Bissau. p.aaby@bandim.org
Biai
Sidu
S
Veirum
Jens Erik
JE
Sodemann
Morten
M
Lisse
Ida
I
Garly
May-Lill
ML
Ravn
Henrik
H
Benn
Christine Stabell
CS
Rodrigues
Amabelia
A
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*
D015721:Diphtheria-Tetanus-Pertussis Vaccine; D008458:Measles Vaccine