VoICE Immunization Evidence: Health inequity

Key Concept

Key Evidence: Nearly a quarter of a million children are born with sickle cell disease in Africa each year. SCD was found to increase the risk of Hib infections by 13-fold and pneumococcal infections by 36 fold. This means that children with SCD stand to benefit enormously from PCV and Hib immunization.

Ramakrishnan, M., Moisi, J.C., Klugman, K., et al 2010. Increased risk of invasive bacterial infections in African people with sickle-cell disease: a systematic review and meta-analysis. The Lancet Infectious Diseases. 10(5)329-37.

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Key Evidence: In a long-term study of Canadian surveillance data researchers found that immunocompromised people were at a 12-fold risk of invasive pneumococcal disease (IPD) compared to healthy people. In addition, the risk of death from IPD in immunocompromised people was found to be 30-80% higher than healthy individuals who had contracted IPD. 10 years after introduction of PCV7 in Canada, the incidence of IPD due to serotypes included in the vaccine had decreased by 90%.

Shigayeva, A., Rudnick, W., Green, K., et al 2016. Invasive pneumococcal disease among immunocompromised persons: implications for vaccination programs. Clinical Infectious Disease. 62:139-47.

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Key Evidence: A study of children under 5 years of age in Dhaka, Bangladesh found that severely malnourished children were nearly 8 times more likely to suffer death from diarrhea than those who were not severely malnourished.

Chisti, M.J., Pietroni, M.A., Smith, J.H., et al 2011. Predictors of death in under-five children with diarrhoea admitted to a critical care ward in an urban hospital in Bangladesh. Acta Paediatrica. 100:e275-9.

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Key Evidence: A study of Kenyan children under 5 years of age found that immunization with polio, BCG, DPT, and measles to be protective against stunting in young children (27% less likely to be stunted than unimmunized children under age 2 years). In addition, children with diarrhea and cough in the 2 weeks prior to the survey were 80-90% more likely to be underweight or to suffer from wasting.

Gewa, C.A. and Yandell, N. 2011. Undernutrition among Kenyan children: contribution of child, maternal and household factors. Public Health Nutrition. 15(6):1029-38.

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Key Evidence: An analysis of the association between undernutrition and mortality in young children revealed that in 60% of deaths due to diarrhea, 52% of deaths due to pneumonia, 45% of deaths due to measles and 57% of deaths attributable to malaria, undernutrition was a contributing factor.

Caulfield, L.E., de Onis, M., and Black, R.E. 2004. Undernutrition as an underlying cause of child deaths associated with diarrhea, pneumonia, malaria and measles. American Journal of Clinical Nutrition. 80:193-8.

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