Transactions of the Royal Society of Tropical Medicine and Hygiene (T ROY SOC TROP MED H )

Publisher: Royal Society of Tropical Medicine and Hygiene, Elsevier

Description

Transactions of the Royal Society of Tropical Medicine and Hygiene publishes original, peer-reviewed articles, and invited reviews across a broad range of topics relevant to the Society's goals, including: clinical tropical medicine and case reports, infectious diseases, parasitology and entomology, microbiology and virology, epidemiology, chemotherapy, immunology, public health, including social science. A key objective is to present the results of research that are broadly intelligible to workers from a range of disciplines. We welcome articles on translational research that may impact directly on clinical and public health practice in developing countries and those describing the application of new technologies in tropical medicine.

Impact factor 1.93

  • Hide impact factor history
     
    Impact factor
  • 5-year impact
    2.46
  • Cited half-life
    0.00
  • Immediacy index
    0.47
  • Eigenfactor
    0.01
  • Article influence
    0.76
  • Website
    Transactions of the Royal Society of Tropical Medicine & Hygiene website
  • Other titles
    Transactions of the Royal Society of Tropical Medicine and Hygiene (Online), Trans R Soc Trop Med Hyg
  • ISSN
    1878-3503
  • OCLC
    53915292
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Elsevier

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author can archive a post-print version
  • Conditions
    • Pre-print allowed on any website or open access repository
    • Voluntary deposit by author of authors post-print allowed on authors' personal website, arXiv.org or institutions open scholarly website including Institutional Repository, without embargo, where there is not a policy or mandate
    • Deposit due to Funding Body, Institutional and Governmental policy or mandate only allowed where separate agreement between repository and the publisher exists.
    • Permitted deposit due to Funding Body, Institutional and Governmental policy or mandate, may be required to comply with embargo periods of 12 months to 48 months .
    • Set statement to accompany deposit
    • Published source must be acknowledged
    • Must link to journal home page or articles' DOI
    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: In 2009, the WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the International Development Research Centre (IDRC) launched a call for innovative community-based ecosystem management research projects for dengue and Chagas disease prevention in low and middle income countries in Latin America and the Caribbean. Eight research institutions were selected. The outputs of these projects led to a better understanding of the interaction between ecological, biological, social and economic (eco-bio-social) determinants of dengue and Chagas disease in Latin America and the Caribbean. Both diseases are considered highly relevant in the regional health agendas. © World Health Organization 2015. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 02/2015; 109(2):89-90.
  • Andrea Caprara, José Wellington De Oliveira Lima, Ana Carolina Rocha Peixoto, Cyntia Monteiro Vasconcelos Motta, Joana Mary Soares Nobre, Johannes Sommerfeld, Axel Kroeger
    [Show abstract] [Hide abstract]
    ABSTRACT: This study intended to implement a novel intervention strategy, in Brazil, using an ecohealth approach and analyse its effectiveness and costs in reducing Aedes aegypti vector density as well as its acceptance, feasibility and sustainability. The intervention was conducted from 2012 to 2013 in the municipality of Fortaleza, northeast Brazil. A cluster randomized controlled trial was designed by comparing ten intervention clusters with ten control clusters where routine vector control activities were conducted. The intervention included: community workshops; community involvement in clean-up campaigns; covering the elevated containers and in-house rubbish disposal without larviciding; mobilization of schoolchildren and senior inhabitants; and distribution of information, education and communication (IEC) materials in the community. Differences in terms of social participation, commitment and leadership were present in the clusters. The results showed the effectiveness of the intervention package in comparison with the routine control programme. Differences regarding the costs of the intervention were reasonable and could be adopted by public health services. Embedding social participation and environmental management for improved dengue vector control was feasible and significantly reduced vector densities. Such a participatory ecohealth approach offers a promising alternative to routine vector control measures. © The author 2015. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 02/2015; 109(2):99-105.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This article provides an overview of three research projects which designed and implemented innovative interventions for Chagas disease vector control in Bolivia, Guatemala and Mexico. The research initiative was based on sound principles of community-based ecosystem management (ecohealth), integrated vector management, and interdisciplinary analysis. The initial situational analysis achieved a better understanding of ecological, biological and social determinants of domestic infestation. The key factors identified included: housing quality; type of peridomestic habitats; presence and abundance of domestic dogs, chickens and synanthropic rodents; proximity to public lights; location in the periphery of the village. In Bolivia, plastering of mud walls with appropriate local materials and regular cleaning of beds and of clothes next to the walls, substantially decreased domestic infestation and abundance of the insect vector Triatoma infestans. The Guatemalan project revealed close links between house infestation by rodents and Triatoma dimidiata, and vector infection with Trypanosoma cruzi. A novel community-operated rodent control program significantly reduced rodent infestation and bug infection. In Mexico, large-scale implementation of window screens translated into promising reductions in domestic infestation. A multi-pronged approach including community mobilisation and empowerment, intersectoral cooperation and adhesion to integrated vector management principles may be the key to sustainable vector and disease control in the affected regions. © World Health Organization 2015. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 02/2015; 109(2):91-98.
  • Juliana Quintero, Tatiana García-Betancourt, Sebastian Cortés, Diana García, Lucas Alcalá, Catalina González-Uribe, Helena Brochero, Gabriel Carrasquilla
    [Show abstract] [Hide abstract]
    ABSTRACT: Long-lasting insecticide-treated net (LLIN) window and door curtains alone or in combination with LLIN water container covers were analysed regarding effectiveness in reducing dengue vector density, and feasibility of the intervention. A cluster randomised trial was conducted in an urban area of Colombia comparing 10 randomly selected control and 10 intervention clusters. In control clusters, routine vector control activities were performed. The intervention delivered first, LLIN curtains (from July to August 2013) and secondly, water container covers (from October to March 2014). Cross-sectional entomological surveys were carried out at baseline (February 2013 to June 2013), 9 weeks after the first intervention (August to October 2013), and 4-6 weeks after the second intervention (March to April 2014). Curtains were installed in 922 households and water container covers in 303 households. The Breteau index (BI) fell from 14 to 6 in the intervention group and from 8 to 5 in the control group. The additional intervention with LLIN covers for water containers showed a significant reduction in pupae per person index (PPI) (p=0.01). In the intervention group, the PPI index showed a clear decline of 71% compared with 25% in the control group. Costs were high but options for cost savings were identified. Short term impact evaluation indicates that the intervention package can reduce dengue vector density but sustained effect will depend on multiple factors. © The author 2015. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 02/2015; 109(2):116-25.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Non-domiciliated (intrusive) triatomine vectors remain a challenge for the sustainability of Chagas disease vector control as these triatomines are able to transiently (re-)infest houses. One of the best-characterized examples is Triatoma dimidiata from the Yucatan peninsula, Mexico, where adult insects seasonally infest houses between March and July. We focused our study on three rural villages in the state of Yucatan, Mexico, in which we performed a situation analysis as a first step before the implementation of an ecohealth (ecosystem approach to health) vector control intervention. The identification of the key determinants affecting the transient invasion of human dwellings by T. dimidiata was performed by exploring associations between bug presence and qualitative and quantitative variables describing the ecological, biological and social context of the communities. We then used a participatory action research approach for implementation and evaluation of a control strategy based on window insect screens to reduce house infestation by T. dimidiata. This ecohealth approach may represent a valuable alternative to vertically-organized insecticide spraying. Further evaluation may confirm that it is sustainable and provides effective control (in the sense of limiting infestation of human dwellings and vector/human contacts) of intrusive triatomines in the region. © The author 2015. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 02/2015; 109(2):143-9.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This project investigates the effectiveness and feasibility of scaling-up an eco-bio-social approach for implementing an integrated community-based approach for dengue prevention in comparison with existing insecticide-based and emerging biolarvicide-based programs in an endemic setting in Machala, Ecuador. An integrated intervention strategy (IIS) for dengue prevention (an elementary school-based dengue education program, and clean patio and safe container program) was implemented in 10 intervention clusters from November 2012 to November 2013 using a randomized controlled cluster trial design (20 clusters: 10 intervention, 10 control; 100 households per cluster with 1986 total households). Current existing dengue prevention programs served as the control treatment in comparison clusters. Pupa per person index (PPI) is used as the main outcome measure. Particular attention was paid to social mobilization and empowerment with IIS. Overall, IIS was successful in reducing PPI levels in intervention communities versus control clusters, with intervention clusters in the six paired clusters that followed the study design experiencing a greater reduction of PPI compared to controls (2.2 OR, 95% CI: 1.2 to 4.7). Analysis of individual cases demonstrates that consideration for contexualizing programs and strategies to local neighborhoods can be very effective in reducing PPI for dengue transmission risk reduction. In the rapidly evolving political climate for dengue control in Ecuador, integration of successful social mobilization and empowerment strategies with existing and emerging biolarvicide-based government dengue prevention and control programs is promising in reducing PPI and dengue transmission risk in southern coastal communities like Machala. However, more profound analysis of social determination of health is called for to assess sustainability prospects. © The author 2015. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 02/2015; 109(2):126-33.
  • Transactions of the Royal Society of Tropical Medicine and Hygiene 02/2015; 109(2):85-8.
  • César Basso, Elsa García da Rosa, Sonnia Romero, Cristina González, Rosario Lairihoy, Ingrid Roche, Ruben M Caffera, Ricardo da Rosa, Marisel Calfani, Eduardo Alfonso-Sierra, Max Petzold, Axel Kroeger, Johannes Sommerfeld
    [Show abstract] [Hide abstract]
    ABSTRACT: Uruguay is located at the southern border of Aedes aegypti distribution on the South American sub-continent. The reported dengue cases in the country are all imported from surrounding countries. One of the cities at higher risk of local dengue transmission is Salto, a border city with heavy traffic from dengue endemic areas. We completed an intervention study using a cluster randomized trial design in 20 randomly selected 'clusters' in Salto. The clusters were located in neighborhoods of differing geography and economic, cultural and social aspects. Entomological surveys were carried out to measure the impact of the intervention on vector densities. Through participatory processes of all stakeholders, an appropriate ecosystem management intervention was defined. Residents collected the abundant small water holding containers and the Ministry of Public Health and the Municipality of Salto were responsible for collecting and eliminating them. Additional vector breeding places were large water tanks; they were either altered so that they could not hold water any more or covered so that oviposition by mosquitoes could not take place. The response from the community and national programme managers was encouraging. The intervention evidenced opportunities for cost savings and reducing dengue vector densities (although not to statistically significant levels). The observed low vector density limits the potential reduction due to the intervention. A larger sample size is needed to obtain a statistically significant difference. © The author 2015. The World Health Organization has granted Oxford University Press permission for the reproduction of this article.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 02/2015; 109(2):134-42.
  • Santosh George, Saravanakumar Puthupalayam Kaliappan, Deepthi Kattula, Sheela Roy, Peter Geldhof, Gagandeep Kang, Jozef Vercruysse, Bruno Levecke
    [Show abstract] [Hide abstract]
    ABSTRACT: It is generally assumed that hookworm infections in humans are caused by Necator americanus and Ancylostoma duodenale. However, previous studies have also reported the presence of the animal hookworm A. ceylanicum in human stools. We determined hookworm infections in children in a tribal community in Tamil Nadu, India, using a semi-nested PCR-RFLP approach. The results indicate that human species account for a majority of the hookworm infections (N. americanus 39/41 [95%]; A. duodenale 6/41 [15%]), whereas the animal hookworm A. ceylanicum only accounts for a minority of the infections (5%; 2/41). The results emphasize the need to consider zoonotic ancylostomiasis while developing strategies to control hookworm infections. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Long-lasting insecticidal net screens (LLIS) fitted to domestic windows and doors in combination with targeted treatment (TT) of the most productive Aedes aegypti breeding sites were evaluated for their impact on dengue vector indices in a cluster-randomised trial in Mexico between 2011 and 2013. Sequentially over 2 years, LLIS and TT were deployed in 10 treatment clusters (100 houses/cluster) and followed up over 24 months. Cross-sectional surveys quantified infestations of adult mosquitoes, immature stages at baseline (pre-intervention) and in four post-intervention samples at 6-monthly intervals. Identical surveys were carried out in 10 control clusters that received no treatment. LLIS clusters had significantly lower infestations compared to control clusters at 5 and 12 months after installation, as measured by adult (male and female) and pupal-based vector indices. After addition of TT to the intervention houses in intervention clusters, indices remained significantly lower in the treated clusters until 18 (immature and adult stage indices) and 24 months (adult indices only) post-intervention. These safe, simple affordable vector control tools were well-accepted by study participants and are potentially suitable in many regions at risk from dengue worldwide
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2015; 109(2):106-115.
  • [Show abstract] [Hide abstract]
    ABSTRACT: In 2003, a study in Mali showed that 87% of episodes of uncomplicated malaria were first treated at home. We investigated whether treatment-seeking patterns in Mali had changed 10 years later. In 2013, we repeated the retrospective treatment-outcome study on 400 children with presumed malaria in the same area. Most children with reported uncomplicated malaria were still first treated at home (76% [196/258] in 2013 vs 85% in 2003; p=0.006), rather than in modern health centres (20% [52/258] in 2013 vs 12% in 2003; p=0.01). Overall, 58% of children with uncomplicated malaria were treated with herbal medicine alone, a significant increase from 24% 10 years earlier (p<0.001). This was associated with an increase in use of Argemone mexicana decoction from 8% to 26% (p<0.001), with a reported cure or improvement in 100% of cases among those aged >5 years. For severe malaria, first treatment was sought less often from a traditional healer compared with 10 years earlier (4% vs 32%; p<0.001) and more often from a modern health centre (29% vs 17%; p=0.04). Two trends that emerged are that there is a greater use of modern health facilities for treatment of severe malaria, and a greater use of traditional medicine alone for treatment of uncomplicated malaria. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Schistosomiasis in returning travellers is one of the most common imported tropical infections with potentially serious complications, which are preventable if diagnosed early. A review was undertaken of consecutive cases of schistosomiasis presenting at the Hospital for Tropical Diseases, London, UK from 1997 to 2012. All 1020 schistosomiasis cases were from Africa and Schistosoma haematobium was the predominant species in those with microscopy confirmed schistosomiasis (74.2%, 204/252). The number of cases of imported schistosomiasis is decreasing steadily as a proportion of travellers seen. The majority of cases were in travellers originating from non-endemic settings (81.8%, 707/864). The most common symptom was of genitourinary complaints (22.6%, 230/1020), predominantly haematuria (17.8%, 181/1020); 36.1% (368) of cases were asymptomatic. Overall 42% had eosinophilia, and 62% of ova positive S. haematobium cases had haematuria on urine dip. Thus, no single screening tool was sufficient to identify or rule out schistosomiasis when used alone. Serology testing was a more sensitive tool in travellers than in other patients (p=0.007). The prevalence of schistosomiasis in presenting travellers is decreasing. The predominant presenting species has shifted from S. mansoni to S. haematobium. No single test can reliably diagnose schistosomiasis, with eosinophilia and urine dip having low sensitivity. Clinicians need to continue to undertake a wide spectrum of diagnostic tests to ensure cases of schistosomiasis are not missed. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Lymphatic filariasis has been targeted for elimination by 2020, and a threshold of 65% coverage of mass drug administration (MDA) has been adopted by the Global Programme to Eliminate Lymphatic Filariasis (GPELF). A recent review by Babu and Babu of 36 studies of MDA for lymphatic filariasis in India found that coverage, defined as receipt of tablets, ranged from 48.8 to 98.8%, while compliance, defined as actual ingestion of tablets, was 22% lower on average. Moreover, the denominator for these coverage figures is the eligible, rather than total, population. By contrast, the 65% threshold, in the original modelling study, refers to ingestion of tablets in the total population. This corresponds to GPELF's use of 'epidemiological drug coverage' as a trigger for the Transmission Assessment Surveys (TAS), which indicate whether to proceed to post-MDA surveillance. The existence of less strict definitions of 'coverage' should not lead to premature TAS that could impair MDA's sustainability. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2015;
  • [Show abstract] [Hide abstract]
    ABSTRACT: We examined the potential sex-differential and non-specific effects of bacille Calmette-Guérin (BCG), diphtheria-tetanus-pertussis (DTP) and measles vaccine (MV) in a rural area of Senegal. The 4133 children born in the area between 1996 and 1999 were included in the study. Vaccinations were provided at three health centres. Vaccine information was collected through 3-monthly home visits. The survival analysis compared the effects of BCG and DTP according to the following sequence of vaccinations: BCG-first, BCG+DTP1-first, or DTP1-first. We compared DTP and MV between 9 and 24 months of age, as 9 months is the minimum age for MV. At 12 months the vaccination coverage was 44%, 46% and 9%, respectively, for BCG, DTP1 and MV. Most children received BCG+DTP1-first and this combination was associated with a significantly lower mortality rate ratio (MRR) of 0.69 (0.53-0.89) compared with unvaccinated children. There was no benefit for children receiving BCG-first or DTP1-first. The female-male MRR was 0.79 (0.64-0.96) among unvaccinated children, but was significantly inversed with 1.45 (1.00-2.10) for children receiving DTP vaccination (test of homogeneity, p=0.006). Children who had received DTP simultaneously with MV or DTP after MV had significantly higher mortality (MRR=2.59 [1.32-5.07]) compared with children having MV-only as their most recent vaccination. After 9 months, the female-male MRR was 0.61 (0.31-1.19) for measles-vaccinated children but remained 1.54 (1.03-2.31) for DTP-vaccinated children who had not received MV (p=0.01). The sequence of routine vaccinations is important for the overall impact on child survival and these vaccines are associated with sex-differential effects. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2015; 109(1):77-84.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Females typically develop higher antibody responses and experience more adverse reactions following vaccination than males. These differences are observed in response to diverse vaccines, including the bacillus Calmette-Guerin vaccine, the measles, mumps and rubella vaccine, the yellow fever virus vaccine and influenza vaccines. Sex differences in the responses to vaccines are observed across diverse age groups, ranging from infants to aged individuals. Biological as well as behavioral differences between the sexes are likely to contribute to differences in the outcome of vaccination between the sexes. Immunological, hormonal, genetic and microbiota differences between males and females may also affect the outcome of vaccination. Identifying ways to reduce adverse reactions in females and increase immune responses in males will be necessary to adequately protect both sexes against infectious diseases. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2015; 109(1):9-15.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Trained immunity reflects the ability of the innate immune system to adapt via epigenetic changes in monocytes, enhancing responses to a range of microbes, thereby potentially reducing infection in high-risk populations. Examples of trained immunity at birth include enhanced resistance to infection in TLR-simulated newborn mice, reduced risk of late onset sepsis with histologic chorioamnionitis and beneficial heterologous effects of neonatal bacille Calmette-Guérin administration in reducing diverse infections during infancy. Future efforts will assess leveraging trained immunity in early life by administering 'stand-alone' innate immune stimuli or (self-)adjuvanted vaccines to protect against a broad range of infections. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2015; 109(1):3-4.
  • [Show abstract] [Hide abstract]
    ABSTRACT: This review discusses three inter-related topics: (1) the immaturity of the neonatal and infant immune response; (2) heterologous immunity, where prior infection history with unrelated pathogens alters disease outcome resulting in either enhanced protective immunity or increased immunopathology to new infections, and (3) epidemiological human vaccine studies that demonstrate vaccines can have beneficial or detrimental effects on subsequent unrelated infections. The results from the epidemiological and heterologous immunity studies suggest that the immune system has tremendous plasticity and that each new infection or vaccine that an individual is exposed to during a lifetime will potentially alter the dynamics of their immune system. It also suggests that each new infection or vaccine that an infant receives is not only perturbing the immune system but is educating the immune system and laying down the foundation for all subsequent responses. This leads to the question, is there an optimum way to educate the immune system? Should this be taken into consideration in our vaccination protocols? © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2015; 109(1):62-69.
  • [Show abstract] [Hide abstract]
    ABSTRACT: WHO recommends delaying measles vaccination (MV) until maternal antibody has waned. However, early MV may improve child survival by reducing mortality from conditions other than measles infection. We tested whether early MV improves child survival compared with later MV. We found 43 studies comparing measles-vaccinated and measles-unvaccinated children; however, only 16 studies had specific information that MV had been provided at 4-13 months of age, many before 9 months of age. In the 10 best studies (4 randomized trials and 6 observational studies) control children did not receive MV during follow-up. In eight of these studies the vaccine efficacy against death (VED) was 60% or more. In four studies with information on MV provided both before and after 12 months of age, the all-cause mortality reduction was significantly larger for children vaccinated in infancy (VED=74%; 95% CI 51-86%) than for children vaccinated after 12 months of age (VED=29%; CI 8-46%). Prevention of measles explained little of the reduction in mortality. In five studies with information on measles infection, VED was 67% (51-78%) and when measles deaths were excluded, VED was only reduced to 65% (47-77%). One natural experiment compared MV at 4-8 months versus MV at 9-11 months of age and found significantly lower all-cause mortality with early vaccination, the difference being 39% (8-60%). Child mortality may be reduced if MV is given earlier than currently recommended by international organizations. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 01/2015; 109(1):16-28.