MEASLES VACCINATION AND CHILDHOOD MORTALITY IN RURAL BANGLADESH
MEASLES VACCINATION AND CHILDHOOD MORTALITY IN RURAL BANGLADESH
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DOI：
10.1093/oxfordjournals.aje.a115086
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发表时间：
1988-12-01
影响因子：
5
通讯作者：
WOJTYNIAK, B
中科院分区：
文献类型：
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作者：
CLEMENS, JD;STANTON, BF;WOJTYNIAK, B
为了确定接种麻疹疫苗是否与孟加拉国农村儿童死亡率的降低有关，作者在四个毗邻地区进行了一项病例对照研究，其中两个地区参加了1982年春季开始的强化麻疹疫苗接种计划。病例为1982年4月至1984年12月期间在四个地区死亡的536名10-60个月大的儿童。从每个病例的四个区域中选择两个年龄和性别匹配的对照；每个对照至少存活到匹配病例的死亡日期。接种麻疹疫苗可使总死亡率按比例降低36%(95%可信区间21%-48%)，直接由麻疹或腹泻、呼吸道疾病或营养不良引起的死亡率降低57%(95%可信区间43%-67%)。在作者将控制措施限制在匹配病例死亡后至少存活一年的儿童之后，接种麻疹疫苗和降低死亡率之间的联系保持不变。此外，1982年接种疫苗的儿童在1983年和1984年的死亡率持续下降。作者得出结论，在这项研究中，接种麻疹疫苗与儿童死亡率的显著和持续降低有关。
To ascertain whether measles vaccination was associated with reduced mortality rates in rural Bangladeshi children, the authors conducted a case-control study in four contiguous areas, two of which had participated in an intensive measles vaccination program which began in the spring of 1982. Cases were 536 children who had died in the four-area region at the age of 10-60 months between April 1982 and December 1984. Two age- and sex-matched controls were selected from the four-area region for each case; each control had survived at least through the date of death of the matched case. Measles vaccination was associated with a 36% (95% confidence interval 21%-48%) proportionate reduction in the overall rate of death and a 57% (95% confidence interval 43%-67%) reduction in the rate of deaths directly attributed to measles or ascribed to diarrhea, respiratory illness, or malnutrition. The association of measles vaccination and reduced mortality remained unchanged after the authors restricted controls to children who had survived at least one year after the deaths of their matched cases. Moreover, children vaccinated in 1982 exhibited a sustained reduction in the rate of death in 1983 and 1984. The authors concluded that measles vaccination was associated with a pronounced and sustained reduction in the rate of death among children in this study.