The Knowledge Hub

What is the Knowledge Hub?

Explore the VoICE Knowledge Hub—a searchable database featuring the latest peer-reviewed research on immunization benefits, especially in low- and middle-income countries. Browse the Knowledge Hub using a variety of different filters to find vaccine evidence based on country, region, topic, or disease. Click on a tag to find more evidence on a specific area, such as the return on investment of vaccines or impacts of infectious disease outbreaks.

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Immunization campaigns provide more equitable access to childhood vaccinations compared to maternal health services

An analysis of survey data in Latin America and Caribbean countries found that DPT3 coverage rates among indigenous children were significantly lower than in children of European or mixed ethnicity in three out of 14 countries, while significant inequities between these groups in coverage of maternal health services, such as antenatal care and delivery by a skilled birth attendant, existed in most of the countries. The greater equity in access to childhood vaccination by ethnic group may be because vaccinations are often delivered in the communities through immunization campaigns, whereas maternal health services require accessing health facilities, which may incur user fees and transportation costs.

Mesenburg MA, Restrepo-Mendez MC, Amigo H et al.. 2018. Ethnic group inequalities in coverage with reproductive, maternal and child health interventions: cross-sectional analyses of national surveys in 16 Latin America and Caribbean countries. Lancet Global Health. 6(8).

Frequent or longer episodes of diarrhea in infancy can lead to chronic health issues in adulthood

Those who experienced more frequent or longer episodes of diarrhea as an infant were more likely to have metabolic syndrome as adults. A longitudinal study in Guatemala found that diarrhea episodes in early infancy are associated with chronic health issues later in life. Each 1% increase in diarrhea burden in children 0-6 months was associated with a 3% increased prevalence in high blood pressure in adulthood. Similarly, a 1% increase in diarrhea burden in older infants 6-12 months was associated with a 4% increased prevalence in elevated waist circumference in adulthood.

DeBoer, M.D., Chen, D., Burt, D.R. et al. 2013. Early childhood diarrhea and cardiometabolic risk factors in adulthood: The Institute of Nutrition of Central America and Panama (INCAP) Nutritional Supplementation Longitudinal Study. Annals of Epidemiology. 23(6).

Diarrhea is associated with pneumonia in undernourished children

In a recent review of data from developing countries, researchers found that episodes of diarrhea may predispose undernourished children to pneumonia.

Schlaudecker, E.P., Steinhoff, M.C. and Moore, S.R.. 2011. Interactions of diarrhea, pneumonia, and malnutrition in childhood: recent evidence from developing countries. Current Opinion in Infectious Diseases. 24(5).

Undernourished children have a higher likelihood for diarrhea and pneumonia but immunization can improve infant growth

Multiple studies show that

  1. Diarrhea and pneumonia impair children’s growth and that underlying malnutrition is a major risk factor for these conditions.
  2. “Episodes of diarrhea may predispose to pneumonia in undernourished children” and
  3. Immunization against influenza (in mothers) and Streptococcus pneumoniae may improve infant growth. In addition, new studies from Bangladesh, Colombia, Ghana, and Israel further support the paradigm that malnutrition is a key risk factor for diarrhea and pneumonia.

Schlaudecker, E.P., Steinhoff, M.C. and Moore, S.R.. 2011. Interactions of diarrhea, pneumonia, and malnutrition in childhood: recent evidence from developing countries. Current Opinion in Infectious Diseases. 24(5).