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Effectiveness of measles vaccination and vitamin A treatment.

AbstractBACKGROUND:
The current strategy utilized by WHO/United Nations Children's Fund (UNICEF) to reach the Global Immunization Vision and Strategy 2010 measles reduction goal includes increasing coverage of measles vaccine, vitamin A treatment and supplementation in addition to offering two doses of vaccine to all children.
METHODS:
We conducted a systematic review of published randomized controlled trials (RCTs) and quasi-experimental (QE) studies in order to determine effect estimates of measles vaccine and vitamin A treatment for the Lives Saved Tool (LiST). We utilized a standardized abstraction and grading format in order to determine effect estimates for measles mortality employing the standard Child Health Epidemiology Research Group Rules for Evidence Review.
RESULTS:
We identified three measles vaccine RCTs and two QE studies with data on prevention of measles disease. A meta-analysis of these studies found that vaccination was 85% [95% confidence interval (CI) 83-87] effective in preventing measles disease, which will be used as a proxy for measles mortality in LiST for countries vaccinating before one year of age. The literature also suggests that a conservative 95% effect estimate is reasonable to employ when vaccinating at 1 year or later and 98% for two doses of vaccine based on serology reviews. We included six high-quality RCTs in the meta-analysis of vitamin A treatment of measles which found no significant reduction in measles morality. However, when stratifying by vitamin A treatment dose, at least two doses were found to reduce measles mortality by 62% (95% CI 19-82).
CONCLUSION:
Measles vaccine and vitamin A treatment are effective interventions to prevent measles mortality in children.
AuthorsChristopher R Sudfeld, Ann Marie Navar, Neal A Halsey
JournalInternational journal of epidemiology (Int J Epidemiol) Vol. 39 Suppl 1 Pg. i48-55 (Apr 2010) ISSN: 1464-3685 [Electronic] England
PMID20348126 (Publication Type: Journal Article, Meta-Analysis, Research Support, Non-U.S. Gov't, Review, Systematic Review)
Chemical References
  • Measles Vaccine
  • Vitamin A
Topics
  • Age Factors
  • Child, Preschool
  • Dose-Response Relationship, Drug
  • Dose-Response Relationship, Immunologic
  • Female
  • Humans
  • Immunization Schedule
  • Infant
  • Male
  • Measles (drug therapy, mortality, prevention & control)
  • Measles Vaccine (administration & dosage)
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Vitamin A (administration & dosage, therapeutic use)
  • Vitamin A Deficiency (complications, drug therapy)

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