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OBJECTIVE To examine the protective efficacy of measles vaccination in infants in a low income country before 9 months of age. DESIGN Randomised clinical trial. PARTICIPANTS 1333 infants aged 4.5 months: 441 in treatment group and 892 in control group. SETTING Urban area in Guinea-Bissau. INTERVENTION Measles vaccination using standard titre(More)
BACKGROUND WHO has recommended vitamin A supplementation for children aged 6 months or older in developing countries at the same time as immunisation. One study has reported significantly lower seroconversion ratios among children who have received vitamin A supplements with measles vaccine at age 6 months. The aim of our study was to assess the effect of(More)
BACKGROUND Previous studies from Africa have suggested that there is little benefit to be gained from early two-dose measles vaccination schedules. Two-dose schedules have been associated with no improvement in coverage due to immunization of the same individuals on both occasions, low return rate, high refusal rate, low vaccine efficacy, and fear of(More)
OBJECTIVE To identify the population risk factors in emergency situations, we studied breastfeeding status as a predictor for child mortality during a war in Guinea-Bissau. METHODS Data on breastfeeding status are routinely collected by the surveillance system of the Bandim Health Project in Bissau. We used data collected during a 3-month period prior to(More)
Previous studies have suggested that the bacille Calmette-Guérin (BCG) vaccine may have a non-specific beneficial effect on childhood survival in areas with high mortality. We examined whether BCG-vaccinated children with a BCG scar or a positive tuberculin reaction had better survival than children without such reactions. As part of an ongoing two-dose(More)
OBJECTIVE To examine in a randomised trial whether a 25% difference in mortality exists between 4.5 months and 3 years of age for children given two standard doses of Edmonston-Zagreb measles vaccines at 4.5 and 9 months of age compared with those given one dose of measles vaccine at 9 months of age (current policy). DESIGN Randomised controlled trial. (More)
BACKGROUND WHO recommends vitamin A supplementation (VAS) at vaccination contacts after six months of age. The effect of this recommendation on mortality has not been evaluated. METHODS We tested the effect of VAS at vaccination contacts on mortality in a randomised trial in Guinea-Bissau. In a subgroup within this trial we studied adverse reactions to(More)
Most areas of health research will have accepted data and a dominating interpretation. If the interpretation is not correct, contradictions will accumulate, and it will eventually become clear that the current interpretation is untenable. In this situation, the best hypothesis is the one that accounts for all of the known data as well as the apparent(More)
Non-specific effects of vaccination may be different for boys and girls. Due to the sequential administration of vaccines, it is difficult to separate the effect of different vaccines. We tested sex-specific effects of diphtheria, tetanus, pertussis (DTP) and polio vaccines and measles vaccines during the recent war (1998) in Guinea-Bissau when there was no(More)
Observational studies and trials from low-income countries indicate that measles vaccine has beneficial nonspecific effects, protecting against non-measles-related mortality. It is not known whether measles vaccine protects against hospital admissions. Between 2003 and 2007, 6417 children who had received the third dose of diphtheria, tetanus, and pertussis(More)