Bandim Health Project, Indepth Network, 1004, Bissau, Guinea-Bissau.
Bandim Health Project, University of Southern Denmark, OPEN, 5000, Odense, Denmark.
Trials. 2022 Apr 23;23(1):349. doi: 10.1186/s13063-022-06291-z.
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.
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.
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.
www.
gov NCT04220671 . Registered on 5 January 2020.
几内亚比绍的麻疹疫苗接种覆盖率较低；目前，不到 80%的儿童在 12 个月之前接种麻疹疫苗。这种低覆盖率阻碍了麻疹的控制。此外，越来越多的证据表明麻疹疫苗具有有益的非特异性效应，可以增强对其他感染的抵抗力。因此，即使儿童没有接触到麻疹病毒，未接种麻疹疫苗的儿童也可能情况更糟。为了提高疫苗接种覆盖率，世界卫生组织建议利用与轻度疾病相关的卫生系统接触来进行疫苗接种。目前，在几内亚比绍，治疗性卫生系统接触并未得到利用。
班迪姆健康项目在几内亚比绍国家医院的儿科病房登记门诊和住院就诊情况。邀请未接种麻疹疫苗、年龄在 9-59 个月、因轻度疾病就诊或从儿科病房出院的儿童参加一项随机试验。在 5400 名儿童中，按照 1:1 的比例随机分为接受标准麻疹疫苗或生理盐水安慰剂组，我们将检验以下假设：在随后的 6 个月内，在出院时提供麻疹疫苗可以降低（复合结局）住院/死亡率风险 25%。所有入组儿童都通过班迪姆健康项目登记系统和电话随访进行随访。前 1000 名入组儿童还通过在入组后第 2、4、7 和 14 天的访谈进行随访。
利用错过的接种机会可以提高疫苗接种覆盖率，并可能改善儿童健康。然而，在没有进一步证据证明麻疹疫苗接种的安全性和潜在益处的情况下，这些治疗性接触不太可能在几内亚比绍用于疫苗接种。
www.。
gov NCT04220671。于 2020 年 1 月 5 日注册。
