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Health effects of utilising hospital contacts to provide measles vaccination to children 9-59 months-a randomised controlled trial in Guinea-Bissau

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Fisker, Ane B ; Martins, Justiniano S D ; Jensen, Andreas M ; Martins, Cesario ; Aaby, Peter ; Thysen, Sanne M. / Health effects of utilising hospital contacts to provide measles vaccination to children 9-59 months-a randomised controlled trial in Guinea-Bissau. In: Trials. 2022 ; Vol. 23, No. 1. pp. 349.

Bibtex

@article{78fbcee7d0004276bca89ab53a91ebce,
title = "Health effects of utilising hospital contacts to provide measles vaccination to children 9-59 months-a randomised controlled trial in Guinea-Bissau",
abstract = "BACKGROUND: Measles vaccination coverage in Guinea-Bissau is low; fewer than 80% of children are currently measles vaccinated before 12 months of age. The low coverage hampers control of measles. Furthermore, accumulating evidence indicates that measles vaccine has beneficial non-specific effects, strengthening the resistance towards other infections. Thus, even if children are not exposed to measles virus, measles-unvaccinated children may be worse off. To increase vaccination coverage, WHO recommends that contacts with the health system for mild illness are utilised to vaccinate. Currently, in Guinea-Bissau, curative health system contacts are not utilised.METHODS: Bandim Health Project registers out-patient consultations and admissions at the paediatric ward of the National Hospital in Guinea-Bissau. Measles-unvaccinated children aged 9-59 months consulting for milder illness or being discharged from the paediatric ward will be invited to participate in a randomised trial. Among 5400 children, randomised 1:1 to receive standard measles vaccine or a saline placebo, we will test the hypothesis that providing a measles vaccine at discharge lowers the risk of admission/mortality (composite outcome) during the subsequent 6 months by 25%. All enrolled children are followed through the Bandim Health Project registration system and through telephone follow-up. The first 1000 enrolled children are furthermore followed through interviews on days 2, 4, 7 and 14 after enrolment.DISCUSSION: Utilising missed vaccination opportunities can increase vaccination coverage and may improve child health. However, without further evidence for the safety and potential benefits of measles vaccination, these curative contacts are unlikely to be used for vaccination in Guinea-Bissau.TRIAL REGISTRATION: www.CLINICALTRIALS: gov NCT04220671 . Registered on 5 January 2020.",
keywords = "Child, Guinea-Bissau, Hospitals, Humans, Infant, Measles Vaccine/adverse effects, Measles/prevention & control, Vaccination",
author = "Fisker, {Ane B} and Martins, {Justiniano S D} and Jensen, {Andreas M} and Cesario Martins and Peter Aaby and Thysen, {Sanne M}",
note = "{\textcopyright} 2022. The Author(s).",
year = "2022",
month = apr,
day = "23",
doi = "10.1186/s13063-022-06291-z",
language = "English",
volume = "23",
pages = "349",
journal = "Trials",
issn = "1745-6215",
publisher = "BioMed Central Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Health effects of utilising hospital contacts to provide measles vaccination to children 9-59 months-a randomised controlled trial in Guinea-Bissau

AU - Fisker, Ane B

AU - Martins, Justiniano S D

AU - Jensen, Andreas M

AU - Martins, Cesario

AU - Aaby, Peter

AU - Thysen, Sanne M

N1 - © 2022. The Author(s).

PY - 2022/4/23

Y1 - 2022/4/23

N2 - BACKGROUND: Measles vaccination coverage in Guinea-Bissau is low; fewer than 80% of children are currently measles vaccinated before 12 months of age. The low coverage hampers control of measles. Furthermore, accumulating evidence indicates that measles vaccine has beneficial non-specific effects, strengthening the resistance towards other infections. Thus, even if children are not exposed to measles virus, measles-unvaccinated children may be worse off. To increase vaccination coverage, WHO recommends that contacts with the health system for mild illness are utilised to vaccinate. Currently, in Guinea-Bissau, curative health system contacts are not utilised.METHODS: Bandim Health Project registers out-patient consultations and admissions at the paediatric ward of the National Hospital in Guinea-Bissau. Measles-unvaccinated children aged 9-59 months consulting for milder illness or being discharged from the paediatric ward will be invited to participate in a randomised trial. Among 5400 children, randomised 1:1 to receive standard measles vaccine or a saline placebo, we will test the hypothesis that providing a measles vaccine at discharge lowers the risk of admission/mortality (composite outcome) during the subsequent 6 months by 25%. All enrolled children are followed through the Bandim Health Project registration system and through telephone follow-up. The first 1000 enrolled children are furthermore followed through interviews on days 2, 4, 7 and 14 after enrolment.DISCUSSION: Utilising missed vaccination opportunities can increase vaccination coverage and may improve child health. However, without further evidence for the safety and potential benefits of measles vaccination, these curative contacts are unlikely to be used for vaccination in Guinea-Bissau.TRIAL REGISTRATION: www.CLINICALTRIALS: gov NCT04220671 . Registered on 5 January 2020.

AB - BACKGROUND: Measles vaccination coverage in Guinea-Bissau is low; fewer than 80% of children are currently measles vaccinated before 12 months of age. The low coverage hampers control of measles. Furthermore, accumulating evidence indicates that measles vaccine has beneficial non-specific effects, strengthening the resistance towards other infections. Thus, even if children are not exposed to measles virus, measles-unvaccinated children may be worse off. To increase vaccination coverage, WHO recommends that contacts with the health system for mild illness are utilised to vaccinate. Currently, in Guinea-Bissau, curative health system contacts are not utilised.METHODS: Bandim Health Project registers out-patient consultations and admissions at the paediatric ward of the National Hospital in Guinea-Bissau. Measles-unvaccinated children aged 9-59 months consulting for milder illness or being discharged from the paediatric ward will be invited to participate in a randomised trial. Among 5400 children, randomised 1:1 to receive standard measles vaccine or a saline placebo, we will test the hypothesis that providing a measles vaccine at discharge lowers the risk of admission/mortality (composite outcome) during the subsequent 6 months by 25%. All enrolled children are followed through the Bandim Health Project registration system and through telephone follow-up. The first 1000 enrolled children are furthermore followed through interviews on days 2, 4, 7 and 14 after enrolment.DISCUSSION: Utilising missed vaccination opportunities can increase vaccination coverage and may improve child health. However, without further evidence for the safety and potential benefits of measles vaccination, these curative contacts are unlikely to be used for vaccination in Guinea-Bissau.TRIAL REGISTRATION: www.CLINICALTRIALS: gov NCT04220671 . Registered on 5 January 2020.

KW - Child

KW - Guinea-Bissau

KW - Hospitals

KW - Humans

KW - Infant

KW - Measles Vaccine/adverse effects

KW - Measles/prevention & control

KW - Vaccination

UR - http://www.scopus.com/inward/record.url?scp=85128774908&partnerID=8YFLogxK

U2 - 10.1186/s13063-022-06291-z

DO - 10.1186/s13063-022-06291-z

M3 - Journal article

C2 - 35461287

VL - 23

SP - 349

JO - Trials

JF - Trials

SN - 1745-6215

IS - 1

M1 - 349

ER -

ID: 77646861