@article{fdi:010063984,
  title = {{S}ex-differential and non-specific effects of routine vaccinations in a rural area with low vaccination coverage : an observational study from {S}enegal},
  author = {{A}aby, {P}. and {N}ielsen, {J}. and {B}enn, {C}. {S}. and {T}rape, {J}ean-{F}ran{\c{c}}ois},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {W}e examined the potential sex-differential and non-specific effects of bacille {C}almette-{G}u,rin ({BCG}), diphtheria-tetanus-pertussis ({DTP}) and measles vaccine ({MV}) in a rural area of {S}enegal. {M}ethods: {T}he 4133 children born in the area between 1996 and 1999 were included in the study. {V}accinations were provided at three health centres. {V}accine information was collected through 3-monthly home visits. {T}he survival analysis compared the effects of {BCG} and {DTP} according to the following sequence of vaccinations: {BCG}-first, {BCG}+{DTP}1-first, or {DTP}1-first. {W}e compared {DTP} and {MV} between 9 and 24 months of age, as 9 months is the minimum age for {MV}. {R}esults: {A}t 12 months the vaccination coverage was 44%, 46% and 9%, respectively, for {BCG}, {DTP}1 and {MV}. {M}ost children received {BCG}+{DTP}1-first and this combination was associated with a significantly lower mortality rate ratio ({MRR}) of 0.69 (0.53-0.89) compared with unvaccinated children. {T}here was no benefit for children receiving {BCG}-first or {DTP}1-first. {T}he female-male {MRR} was 0.79 (0.64-0.96) among unvaccinated children, but was significantly inversed with 1.45 (1.00-2.10) for children receiving {DTP} vaccination (test of homogeneity, p=0.006). {C}hildren who had received {DTP} simultaneously with {MV} or {DTP} after {MV} had significantly higher mortality ({MRR}=2.59 [1.32-5.07]) compared with children having {MV}-only as their most recent vaccination. {A}fter 9 months, the female-male {MRR} was 0.61 (0.31-1.19) for measles-vaccinated children but remained 1.54 (1.03-2.31) for {DTP}-vaccinated children who had not received {MV} (p=0.01). {C}onclusions: {T}he sequence of routine vaccinations is important for the overall impact on child survival and these vaccines are associated with sex-differential effects.},
  keywords = {{BCG} ; {DTP} ; {M}easles vaccine ; {N}on-specific effects of vaccines ; {S}equence of vaccinations ; {S}ex-differential effects ; {SENEGAL}},
  booktitle = {},
  journal = {{T}ransactions of the {R}oyal {S}ociety of {T}ropical {M}edicine and {H}ygiene},
  volume = {109},
  numero = {1},
  pages = {77--84},
  ISSN = {0035-9203},
  year = {2015},
  DOI = {10.1093/trstmh/tru186},
  URL = {https://www.documentation.ird.fr/hor/fdi:010063984},
}