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The effect of high-dose vitamin A supplementation administered with BCG vaccine at birth may be modified by subsequent DTP vaccination

机译:婴儿接种BCG疫苗时补充大剂量维生素A的效果可能会因随后的DTP疫苗接种而改变

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摘要

Unexpectedly, we found no overall beneficial effect on mortality in a randomised trial of vitamin A supplementation (VAS) or placebo administered with BCG vaccine at birth in Guinea-Bissau. We conducted an explorative analysis to examine whether subsequent diphtheria-tetanus-pertussis (DTP) vaccinations had modified the effect of VAS at birth. VAS was associated with a weak tendency for decreased mortality as long as BCG was the most recent vaccination, the mortality rate ratio being 0.86 (0.48-1.54); 0.82 (0.32-2.08) in girls and 0.89 (0.43-1.88) in boys. However, after DTP vaccination VAS at birth was associated with increased mortality in girls (2.19 (1.09-4.38)), whereas no difference was seen for boys (0.90 (0.44-1.82)) (p=0.08 for equal effect of VAS in the two sexes if DTP is the last vaccine). The explanation for the lack of beneficial effect in our setting may have been that VAS at birth interacted negatively with subsequent DTP vaccinations in girls.
机译:出乎意料的是,在几内亚比绍出生时,在补充维生素A补充剂(VAS)或安慰剂与BCG疫苗一起接种的随机试验中,我们没有发现对死亡率有总体益处。我们进行了一项探索性分析,以检查随后的白喉-破伤风-百日咳(DTP)疫苗接种是否改变了出生时VAS的效果。只要最近一次接种BCG疫苗,VAS的死亡率降低趋势就很弱,死亡率比率为0.86(0.48-1.54);女孩为0.82(0.32-2.08),男孩为0.89(0.43-1.88)。但是,在接种DTP疫苗后,出生时VAS与女孩死亡率增加相关(2.19(1.09-4.38)),而男孩(0.90(0.44-1.82))则无差异(p = 0.08,VAS在婴儿中的效果相同)。如果最后一个疫苗是DTP,则为两个性别)。在我们的环境中缺乏有益效果的原因可能是出生时的增值服务与女孩随后的DTP疫苗接种负相关。

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