Sex-differential effects on mortality of BCG and diphtheria-tetanus-pertussis vaccines in a rural area with high vaccination coverage: observational study from Senegal.

摘要: BACKGROUND Diphtheria-tetanus-pertussis (DTP) may be associated with increased female mortality; the effect of co-administration BCG is not known. METHODS Between 1989 and 1997, we examined male mortality rates in rural Senegal where 7824 infants received first dose DTP inactivated polio vaccine (DTP-IPV) BCG. Subsequent doses DTP-IPV were administered alone. We analysed according to sex number vaccine. RESULTS DTP-IPV1 simultaneously reduced from 60/1000 person-years unvaccinated girls 35/1000 person-years, but subsequent 45/1000 person-years. Among boys, 72/1000 decreased further 34/1000 In age-adjusted analyses, female-male rate ratios 0.83(95% CI 0.50-1.40) among children 0.58 (95% 0.35-0.96) vaccinated DTP-IPV1, 1.17 0.67-2.03) after DTP-IPV2, 1.63 0.86-3.10) DTP-IPV3. Difference vaccination coverage could explain these sex-differential patterns; had significantly better weight-for-age than boys so nutritional status did increase CONCLUSIONS Whereas co-administered was lower mortality, vaccinations an relative mortality.