Objective: To assess the relationship between childhood immunization and mortality risks for nonvaccine-preventable diseases (competing mortality risks, or CMR) in Kenya.
Study Design: A combination of the Global Burden of Disease and Demographic Health Survey data was used to measure basic vaccination status, CMR, and control variables for each child in the Demographic Health Survey data. A longitudinal analysis was performed. This uses within-mother variation between children to compare the vaccine decisions for different children, who are exposed to different mortality risks. The analysis also distinguishes between overall and disease-specific risks.
Results: The study included 15 881 children born between 2009 and 2013, who were at least 12 months old at the time of interview and not part of a twin birth. Mean basic vaccination rates ranged from 27.1% to 90.2% and mean CMR from 13.00 to 738.32 deaths per 100 000 across different counties. A one-unit increase in mortality risk from diarrhea, the most prevalent disease among children in Kenya, is associated with a 1.1 percentage point decline in basic vaccination status. In contrast, mortality risks for other diseases and HIV increase the likelihood of vaccination. The effect of CMR was found to be stronger for children with higher birth orders.
Conclusions: A significant negative correlation between severe CMR and vaccination status was found, which has important implications for immunization policies, particularly in Kenya. Interventions aimed at reducing the most severe CMR, such as diarrhea, and targeted toward multiparous mothers may improve childhood immunization coverage.
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http://dx.doi.org/10.1016/j.jpeds.2023.113590 | DOI Listing |
Harv Rev Psychiatry
December 2024
From McLean Hospital (Mr. Mermin and Dr. Choi-Kain) Belmont, MA; Harvard College (Ms. Steigerwald); Harvard Medical School (Dr. Choi-Kain).
Borderline personality disorder (BPD) has been described as a condition of intolerance of aloneness. This characteristic drives distinguishing criteria, such as frantic efforts to avoid abandonment. Both BPD and loneliness are linked with elevated mortality risk and multiple negative health outcomes.
View Article and Find Full Text PDFDiabetes
January 2025
Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia.
Individuals with type 2 diabetes are at high risk of postprandial falls in blood pressure (BP) (i.e., a reduction in systolic BP of ≥20mmHg, termed postprandial hypotension (PPH)), which increases the risk of falls and mortality.
View Article and Find Full Text PDFClin Transplant
January 2025
Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, Bunkyo-Ku, Tokyo, Japan.
Background: Pleural effusion and ascites developing after allogeneic hematopoietic stem cell transplantation (allo-SCT) are generally associated with inferior overall survival (OS); however, the prognostic value of pretransplant effusion on transplant outcomes remained unclear.
Methods: We retrospectively evaluated minimal pleural effusion and ascites detected by computed tomography in 248 consecutive adult patients who underwent their first allo-SCT from January 2007 to December 2022.
Results: Forty-eight patients demonstrated minimal pleural effusion or ascites within 100 days before transplantation (Effusion group) and the other 200 had no effusion (No effusion group).
PLoS One
January 2025
Department of Clinical Pharmacy, College of Pharmacy, University of Baghdad, Baghdad, Iraq.
Cancer-associated thrombosis (CAT) can increase morbidity and mortality for cancer patients. Therefore, guidelines recommend predicting VTE risk and thromboprophylaxis for high-risk patients. Many studies critique oncologists' adherence to thromboprophylaxis guidelines for cancer patients.
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