National immunisation campaigns with oral polio vaccine may reduce all-cause mortality: Analysis of 2004–2019 demographic surveillance data in rural Bangladesh

Sebastian Nielsen*, Md Abdul Khalek, Christine Stabell Benn, Peter Aaby, Syed Manzoor Ahmed Hanifi

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Abstract

Background: West African studies have suggested that national immunisation campaigns with oral polio vaccine (C-OPV) may non-specifically reduce all-cause child mortality rate by 15–25%. We investigated whether C-OPVs had similar non-specific effects in rural Bangladesh from 2004 to 2019. Methods: Chakaria, is a health and demographic surveillance system (HDSS) in Southern Bangladesh. From 2004–2011 the HDSS covered a random sample of households; from 2012 to 2019 it covered a random sample of villages. Using Cox proportional hazards models, we calculated hazard ratios (HR) comparing mortality for children under 3 years of age after C-OPV versus before C-OPV to assess the effect of receiving a C-OPV. We allowed for different baseline hazard function in the two periods (2004–2011, 2012–2019), with separate models for each period. Findings: There were 768 deaths (2.1%) amongst 36,176 children. The HR after C-OPV was 0.69 (95% confidence interval: 0.52–0.90). National campaigns providing vitamin A or measles vaccine did not have similar effects. Each additional dose of C-OPV was associated with a reduction in the mortality rate by 6% (−2 to 13%). The number needed to treat with C-OPV to save one life between 0 and 35 months of age was 88 (81–96). Interpretation: This is the fourth study to show that C-OPV has beneficial non-specific effects on child survival. All studies have shown a beneficial effect of C-OPV on child health. Stopping OPV as planned after polio eradication without any mitigation plan could have detrimental effects for overall child health in low-income countries. Funding: The Chakaria HDSS was funded by international sponsors. No sponsor had any influence on the preparation of the article.

OriginalsprogEngelsk
Artikelnummer100886
TidsskrifteClinicalMedicine
Vol/bind36
Antal sider7
ISSN2589-5370
DOI
StatusUdgivet - jun. 2021

Bibliografisk note

Funding Information:
This research study is funded by core donors who provide unrestricted support to icddr,b for its operations and research. Current donors providing unrestricted support include the Governments of Bangladesh, Canada, Sweden and the UK.

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