Estimasi Pengaruh Vaksin DPT pada Kematian Anak: Analisis Multivariabel data Survailan Demografi dan Kesehatan di Kabupaten Purworejo
Abstrak: Recent controversial
reports suggest that
recipients of one dose
of DTP vaccines had higher mortality than
children who had received
no DTP vaccine. We reanalyzed data on vaccination and
child survival collected from demographic and health
surveillance to challenge previous findings.
Objectives: To estimate specific and non-specific effects of DTP
vaccination on child mortality age 1-24 months under routine vaccination program
in Indonesia.
Methods: A longitudinal surveillance
data provided information
on 5647 children below
24 months of age who received DTP
and other vaccinations. The main outcome measure was all-cause mortality.
Background factors associated with
mortality were collected, such as:
sex, birth order, dead
sibling, mother’s education
and family size. We assessed DTP
vaccinations as an independent
factor with other variables in Cox’s
regression models with time dependent
covariates.
Results: There is no
sex differential of mortality
among children in
Purworejo even after
considering other factors using
Cox regression analysis. Mortality was lower
in the group
vaccinated with DTP vaccine
compared with those not
vaccinated, the relative
risk of mortality (RR)
being 0.56 with 95%
confidence interval (CI)
is 0.453–0.690. After controlling
for the background
factors, recipient of DPT
vaccines continued to
have a lower mortality with RR=0.74 (95% CI:
0.586–0.925). BCG and
measles vaccines have stronger
non-specific effects
compared to effects
of DTP vaccines.
Conclusion: Through specific
effect against targeted
diseases and a
non-specific benefit against
others illnesses, the study showed
reduced mortality among children
who received DTP vaccine. There is no
reason to change current vaccination policy because DTP was not associated with any
harmful effect among
girls.
Penulis: Siswanto Agus Wilopo
Kode Jurnal: jpkedokterandd090175
