AI Article Synopsis
- The study examined the effects of DTP vaccination on mortality in children, particularly focusing on differences between genders.
- Results indicated that DTP vaccination led to significantly higher mortality rates in girls compared to boys after receiving BCG vaccination.
- The findings supported the original hypotheses that DTP vaccination increases mortality in girls and raises the female/male mortality rate ratio.
Article Abstract
Background: Ten years ago, we formulated two hypotheses about whole-cell diphtheria-tetanus-pertussis (DTP) vaccination: first, when given after BCG, DTP increases mortality in girls and, second, following DTP there is an increase in the female/male mortality rate ratio (MRR). A recent review by WHO found no convincing evidence that DTP increases mortality in females.
Methods: We used previous DTP reviews as well as the recent WHO review for assessing the hypotheses. As pre-specified we excluded studies with survival or frailty bias; if children had received BCG and DTP simultaneously; and if the children had received neonatal vitamin A.
Results: In seven studies of BCG-vaccinated children, DTP vaccination was associated with a 2.54 (95% CI 1.68-3.86) increase in mortality in girls (with no increase in boys [ratio 0.96, 0.55-1.68]). In 10 studies of BCG-vaccinated children, the female-to-male mortality ratio was 2.45 (1.48-4.06) times higher after DTP than before DTP. In 15 studies of children who had received DTP after previous BCG vaccination, mortality was 1.53 (1.21-1.93) times higher in girls than boys. The findings were similar in studies conducted before and after formulation of the hypotheses.
Conclusions: The two hypotheses were confirmed in the studies that fulfilled pre-specified criteria.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5155548 | PMC |
| http://dx.doi.org/10.1093/trstmh/trw073 | DOI Listing |
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