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Int J Epidemiol. 2010 Apr;39 Suppl 1:i48-55. doi: 10.1093/ije/dyq021.

Effectiveness of measles vaccination and vitamin A treatment.

Author information

1
Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD 21205, USA. csudfeld@jhsph.edu

Abstract

BACKGROUND:

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.

PMID:
20348126
PMCID:
PMC2845860
DOI:
10.1093/ije/dyq021
[Indexed for MEDLINE]
Free PMC Article

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