@article{fdi:010068319,
  title = {{S}ex-differential effects on mortality of {BCG} and diphtheria-tetanus-pertussis vaccines in a rural area with high vaccination coverage : 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: {D}iphtheria-tetanus-pertussis ({DTP}) may be associated with increased female mortality; the effect of co-administration with {BCG} is not known. {M}ethods: {B}etween 1989 and 1997, we examined female and male mortality rates in rural {S}enegal where 7824 infants received the first dose of {DTP} and inactivated polio vaccine ({DTP}-{IPV}) with {BCG}. {S}ubsequent doses of {DTP}-{IPV} were administered alone. {W}e analysed mortality according to sex and number of doses of {DTP}-{IPV} vaccine. {R}esults: {BCG} and {DTP}-{IPV}1 simultaneously reduced mortality from 60/1000 person-years in unvaccinated girls to 35/1000 person-years, but mortality increased with subsequent doses of {DTP}-{IPV} to 45/1000 person-years. {A}mong boys, {BCG} and {DTP}-{IPV}1 simultaneously reduced mortality from 72/1000 person-years to 60/1000 person-years and mortality decreased further with subsequent doses of {DTP}-{IPV} to 34/1000 person-years. {I}n age-adjusted analyses, female-male mortality rate ratios were 0.83(95% {CI} 0.50-1.40) among unvaccinated children and 0.58 (95% {CI} 0.35-0.96) among children vaccinated simultaneously with {BCG} and {DTP}-{IPV}1, but increased to 1.17 (95% {CI} 0.67-2.03) after {DTP}-{IPV}2, and 1.63 (95% {CI} 0.86-3.10) after {DTP}-{IPV}3. {D}ifference in vaccination coverage could not explain these sex-differential patterns; girls had significantly better weight-for-age than boys so nutritional status did not explain the increase in female mortality after {DTP}-{IPV}3. {C}onclusions: {W}hereas {BCG} co-administered with {DTP}-{IPV} was associated with lower female than male mortality, subsequent {DTP}-{IPV} vaccinations were associated with an increase in female mortality relative to male mortality.},
  keywords = {{BCG} ; {D}iphtheria-tetanus-pertussis vaccine ; {I}nactivated polio vaccine ; {N}on-specific effects of vaccines ; {S}ex-differential effects of vaccines ; {SENEGAL}},
  booktitle = {},
  journal = {{T}ransactions of the {R}oyal {S}ociety of {T}ropical {M}edicine and {H}ygiene},
  volume = {110},
  numero = {9},
  pages = {527--533},
  ISSN = {0035-9203},
  year = {2016},
  DOI = {10.1093/trstmh/trw059},
  URL = {https://www.documentation.ird.fr/hor/fdi:010068319},
}