Should infant girls receive micronutrient supplements?
BACKGROUND
We have proposed the hypothesis that the combination of vitamin A supplementation and diphtheria-tetanus-pertussis (DTP) vaccination may be associated with increased mortality in girls. Recent zinc/folic acid (FA) and iron supplementation trials did not find any beneficial effects on mortality. We reviewed the studies for evidence of a negative interaction between zinc/folic acid/iron and DTP vaccination in girls.


METHODS
Based on the published papers, we calculated age- and sex-specific mortality estimates. No vaccination status data were provided.


RESULTS
Both zinc/FA and iron seemed to have a sex- and age-differential effect, the effect being less beneficial in the youngest girls who are most likely to have DTP vaccine as their most recent vaccination.


CONCLUSIONS
Like vitamin A, zinc/FA and iron may not benefit the youngest girls. The question is whether this is inherent in girls or due to an interaction with some environmental factor like DTP.
Benn
Christine Stabell
CS
Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau. cb@ssi.dk
Lund
Sofia
S
Fisker
Ane
A
Jørgensen
Mathias Jul
MJ
Aaby
Peter
P
D000367:Age Factors; D046688:Child Mortality; D002675:Child, Preschool; D019587:Dietary Supplements / Q000009:adverse effects*; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000009:adverse effects*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007501:Iron / Q000009:adverse effects; D008297:Male; D018977:Micronutrients / Q000009:adverse effects*; D012737:Sex Factors; D014801:Vitamin A / Q000009:adverse effects; D015032:Zinc / Q000009:adverse effects
D015721:Diphtheria-Tetanus-Pertussis Vaccine; D018977:Micronutrients; D014801:Vitamin A; D007501:Iron; D015032:Zinc