Evidence map›Paper›PMID 35618557›Full record

Trial reportVaccine2022

Non-specific effects of BCG and DTP vaccination on infant mortality: An analysis of birth cohorts in Ghana and Tanzania.

M K Quinn, Karen M Edmond, Wafaie W Fawzi, Lisa Hurt, Betty R Kirkwood, Honorati Masanja, Alfa J Muhihi, Sam Newton, Ramadhani A Noor, Paige L Williams and 2 more

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Vaccine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.8field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. The 2024 resurgence ofFrontiers in public health · 2025
    Article
  5. Article
  6. Effects of SilirumAnimals : an open access journal from MDPI · 2023
    Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 8 institutions in 4 countries.

M K QuinnDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
Karen M EdmondDepartment of Women and Children's Health, Kings College London, United Kingdom.
Wafaie W FawziDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA.
Lisa HurtDivision of Population Medicine, Cardiff University School of Medicine, Cardiff, UK.
Betty R KirkwoodDepartment of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Honorati MasanjaIfakara Health Institute, Dar es Salaam, Tanzania.
Alfa J MuhihiIfakara Health Institute, Dar es Salaam, Tanzania.
Sam NewtonKwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana; Kintampo Health Research Centre, Kintampo, Ghana.
Ramadhani A NoorDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA.
Paige L WilliamsDepartment of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA.
Christopher R SudfeldDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA.
Emily R SmithDepartment of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Global Health, George Washington University Milken Institute School of Public Health, Washington, DC, USA; Department of Exercise and Nutrition Sciences, George Washington University Milken Institute School of Public Health, Washington, DC, USA. Electronic address: EmilySmith@gwu.edu.
Harvard University · USHarvard Global Health Institute · USIfakara Health Institute · TZCardiff University · GBGeorge Washington University · USKing's College London · GBKwame Nkrumah University of Science and Technology · GHLondon School of Hygiene & Tropical Medicine · GB

Funding

BIOSTATISTICS/EPIDEMIOLOGY TRAINING GRANTS IN AIDST32AI007358 · NIAID · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI Michael David Hughes · 1989 to 2026
$12.4M
NIAID NIH HHS T32 AI007358
6 · The paper itself

Abstract

backgroundVaccines may induce non-specific effects on survival and health outcomes, in addition to protection against targeted pathogens or disease. Observational evidence suggests that infant Baccillus Calmette-Guérin (BCG) vaccination may provide non-specific survival benefits, while diphtheria-tetanus-pertussis (DTP) vaccination may increase the risk of mortality. Non-specific vaccine effects have been hypothesized to modify the effect of neonatal vitamin A supplementation (NVAS) on mortality.

methods22,955 newborns in Ghana and 31,999 newborns in Tanzania were enrolled in two parallel, randomized, double-blind, placebo-controlled trials of neonatal vitamin A supplementation from 2010 to 2014 and followed until 1-year of age. Cox proportional hazard models were used to estimate associations of BCG and DTP vaccination with infant survival.

resultsBCG vaccination was associated with a decreased risk of infant mortality after controlling for confounders in both countries (Ghana adjusted hazard ratio (aHR): 0.51, 95% CI: 0.38-0.68; Tanzania aHR: 0.08, 95% CI: 0.07-0.10). Receiving a DTP vaccination was associated with a decreased risk of death (Ghana aHR: 0.39, 95% CI: 0.26-0.59; Tanzania aHR: 0.19, 95% CI: 0.16-0.22). There was no evidence of interaction between BCG or DTP vaccination status and infant sex or NVAS.

conclusionWe demonstrated that BCG and DTP vaccination were associated with decreased risk of infant mortality in Ghana and Tanzania with no evidence of interaction between DTP or BCG vaccination, NVAS, and infant sex. Our study supports global recommendations on BCG and DTP vaccination and programmatic efforts to ensure all children have access to timely vaccination. CLINICAL TRIALS REGISTRATION: Ghana (Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12610000582055) and Tanzania (ANZCTR: ACTRN12610000636055).

Indexed as

BCG VaccineDiphtheria-Tetanus-Pertussis VaccineInfant MortalityBirth CohortFemaleGhanaHumansInfantInfant, NewbornMaleSex FactorsTanzaniaVaccinationVitamin ABCG VaccineDiphtheria-Tetanus-Pertussis VaccineVitamin ABCG VaccineDTP VaccineInfant mortalityVitamin A

Identifiers

PMID35618557
PMCPMC9194613
OpenAlexW4281390815

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.