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IJE Advance Access published online on January 15, 2009
International Journal of Epidemiology, doi:10.1093/ije/dyn364
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Should infant girls receive micronutrient supplements?

Christine Stabell Benn1,2,*, Sofia Lund1,2, Ane Fisker1,2, Mathias Jul Jørgensen1,2 and Peter Aaby1,2

1Bandim Health Project, INDEPTH Network, Bissau, Guinea-Bissau.
2Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark.

*Corresponding author. Statens Serum Institut, Artillerivej 5, 2300 Copenhagen S, Denmark. E-mail: cb{at}ssi.dk


  Abstract

Background We have proposed the hypothesis that the combination of vitamin A supplementation and diphtheria-tetanus-pertussis (DTP) vaccination may be associated with increased mortality in girls. Recent zinc/folic acid (FA) and iron supplementation trials did not find any beneficial effects on mortality. We reviewed the studies for evidence of a negative interaction between zinc/folic acid/iron and DTP vaccination in girls.

Methods Based on the published papers, we calculated age- and sex-specific mortality estimates. No vaccination status data were provided.

Results Both zinc/FA and iron seemed to have a sex- and age-differential effect, the effect being less beneficial in the youngest girls who are most likely to have DTP vaccine as their most recent vaccination.

Conclusions Like vitamin A, zinc/FA and iron may not benefit the youngest girls. The question is whether this is inherent in girls or due to an interaction with some environmental factor like DTP.

Keywords Vitamin A, zinc, iron, sex, DTP vaccine, child mortality

Accepted 9 December 2008


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