The frailty hypothesis revisited: mainly weak children die of measles.

摘要: Abstract It has been suggested that measles infection mainly kills frail children who are likely to die anyhow of other infections. If were true, the proportion should increase after introduction vaccination and post-measles mortality compared with in uninfected when case fatality declines no longer dying measles. The latter deduction was investigated Niakhar, Senegal, where declined markedly. Measles studied Niakhar during 12 years from 1983 1994. We long-term periods both high low fatality. acute rate (CFR) 6.5% 1983–1986 1.5% 1987–1994, an age-adjusted decline 66% (RR=0.34 (0.19–0.58)). Between first year by 35% (RR=0.65 (0.37–1.16)), pattern being same second third (RR=0.63 (0.33–1.21)). This reduction could not be related immunization, treatment Vitamin A, or prophylactic use antibiotics. Controlling for age, season, similar fall non-measles-related between two (mortality ratio=0.72 (0.64–0.80)). Since survivors as large among children, did lead accumulation children. doubt ever eliminated weak children; it always killed a broad spectrum most whom “fit survive”. Hence, seems unlikely contributed survival more