A randomized trial of a standard dose of Edmonston-Zagreb measles vaccine given at 4.5 months of age: effect on total hospital admissions.
A randomized trial of a standard dose of Edmonston-Zagreb measles vaccine given at 4.5 months of age: effect on total hospital admissions.
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DOI：
10.1093/infdis/jit804
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发表时间：
2014-06-01
期刊：
影响因子：
--
通讯作者：
Garly ML
中科院分区：
文献类型：
--
作者：
Martins CL;Benn CS;Andersen A;Balé C;Schaltz-Buchholzer F;Do VA;Rodrigues A;Aaby P;Ravn H;Whittle H;Garly ML
低收入国家的观察性研究和试验表明，麻疹疫苗具有有益的非特异性作用，可以预防非麻疹相关死亡。目前尚不清楚麻疹疫苗是否能预防住院。在2003年至2007年期间，6417名接种了第三剂白喉、破伤风和百日咳疫苗的儿童被随机分配到4.5个月时接种麻疹疫苗或不接种麻疹疫苗;所有儿童在9个月大时接种麻疹疫苗。使用来自几内亚比绍比绍国家儿科病房的入院数据，我们在考克斯模型中比较了入组和9个月接种疫苗之间的入院率，提供了接种麻疹疫苗与未接种麻疹疫苗的入院风险率比（HRR）。所有分析均按性别和接受新生儿维生素A补充剂（NVAS）分层进行。入组前，两组的入院率相似。入组后，麻疹疫苗组的入院HRR为0.70（95%置信区间[CI]，0.52 - 0.95），女孩的比率为0.53（95% CI，0.32 - 0.86），男孩为0.86（95% CI，0.58 -1.26）。对于未接受NVAS的儿童，入院HRR为0.53（95%CI，0.34 - 0.84），女孩的影响为0.30（95%CI，0.13 - 0.70），男孩为0.73（95%CI，0.42 -1.28）（P = 0.08，相互作用检验）。麻疹感染（入院HRR，0 [95%CI，0-.24]）和呼吸道感染（入院HRR，0.37 [95%CI，.16-.89]）的入院率分别显著降低。早期麻疹疫苗可能对婴儿发病模式和医疗保健费用有重大益处。NCT00168558。
Observational studies and trials from low-income countries indicate that measles vaccine has beneficial nonspecific effects, protecting against non–measles-related mortality. It is not known whether measles vaccine protects against hospital admissions. Between 2003 and 2007, 6417 children who had received the third dose of diphtheria, tetanus, and pertussis vaccine were randomly assigned to receive measles vaccine at 4.5 months or no measles vaccine; all children were offered measles vaccine at 9 months of age. Using hospital admission data from the national pediatric ward in Bissau, Guinea-Bissau, we compared admission rates between enrollment and the 9-month vaccination in Cox models, providing admission hazard rate ratios (HRRs) for measles vaccine versus no measles vaccine. All analyses were conducted stratified by sex and reception of neonatal vitamin A supplementation (NVAS). Before enrollment the 2 groups had similar admission rates. Following enrollment, the measles vaccine group had an admission HRR of 0.70 (95% confidence interval [CI], .52–.95), with a ratio of 0.53 (95% CI, .32–.86) for girls and 0.86 (95% CI, .58–1.26) for boys. For children who had not received NVAS, the admission HRR was 0.53 (95% CI, .34–.84), with an effect of 0.30 (95% CI, .13–.70) for girls and 0.73 (95% CI, .42–1.28) for boys (P = .08, interaction test). The reduction in admissions was separately significant for measles infection (admission HRR, 0 [95% CI, 0–.24]) and respiratory infections (admission HRR, 0.37 [95% CI, .16–.89]). Early measles vaccine may have major benefits for infant morbidity patterns and healthcare costs. NCT00168558.
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影响因子：
28.2
作者：
AABY, P;BUKH, J;SMITS, AJ
通讯作者：
SMITS, AJ
影响因子：
6.4
作者：
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WOJTYNIAK, B
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2.9
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影响因子：
5.5
作者：
Garly, ML;Balé, C;Whittle, HC
通讯作者：
Whittle, HC