title: Thymus size at 6 months of age and subsequent child mortality.
abstract: OBJECTIVE
  To examine determinants of thymus size at age 6 months and investigate whether thymus size at this age is a determinant of subsequent mortality.
  
  
  METHODS
  Thymus size was measured by transsternal sonography in 923 6-month-old children participating in a measles vaccination trial in Guinea-Bissau.
  
  
  RESULTS
  Thymus size was strongly associated with anthropometric measurements. Boys had larger thymuses than girls, controlling for anthropometry. Crying during sonography made the thymus appear smaller. Children who were not vaccinated with Bacille Calmette-Guérin (BCG) or were vaccinated with BCG in the preceding 4 weeks before inclusion into the study had larger thymuses. Children who had malaria or had been treated with chloroquine or Quinimax in the previous week before inclusion had smaller thymuses. Controlled for background factors associated with thymus size and mortality, small thymus size remained a strong and independent risk factor for mortality (hazard ratio = 0.31; 95% confidence interval = 0.18 to 0.52).
  
  
  CONCLUSIONS
  Small thymus size at age 6 months is a strong risk factor for mortality. To prevent unnecessary deaths, it is important to identify preventable factors predisposing to small thymus size.
authors.affiliation: Projecto de Saúde de Bandim, INDEPTH Network, Bissau, Guinea-Bissau. mlg.pvb@dadlnet.dk
authors.forename: May-Lill
authors.initials: ML
authors.lastname: Garly
authors.forename: Sisse Lecanda
authors.initials: SL
authors.lastname: Trautner
authors.forename: Charlotte
authors.initials: C
authors.lastname: Marx
authors.forename: Kamilla
authors.initials: K
authors.lastname: Danebod
authors.forename: Jens
authors.initials: J
authors.lastname: Nielsen
authors.forename: Henrik
authors.initials: H
authors.lastname: Ravn
authors.forename: Cesário Lourenco
authors.initials: CL
authors.lastname: Martins
authors.forename: Carlito
authors.initials: C
authors.lastname: Balé
authors.forename: Peter
authors.initials: P
authors.lastname: Aaby
authors.forename: Ida Maria
authors.initials: IM
authors.lastname: Lisse
mesh_terms: D001500:BCG Vaccine; D002648:Child; D046688:Child Mortality; D002738:Chloroquine / Q000494:pharmacology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008458:Measles Vaccine / Q000627:therapeutic use; D011803:Quinine / Q000494:pharmacology; D012307:Risk Factors; D013949:Thymus Extracts / Q000378:metabolism; D013950:Thymus Gland / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D014463:Ultrasonography / Q000379:methods
chemical_list: D001500:BCG Vaccine; D008458:Measles Vaccine; D013949:Thymus Extracts; D002738:Chloroquine; D011803:Quinine