Morbidity benefit conferred by childhood immunisation in relation to maternal HIV status: a meta-analysis of demographic and health surveys

Hum Vaccin Immunother. 2018;14(10):2414-2426. doi: 10.1080/21645515.2018.1515453. Epub 2018 Sep 13.


The study determined the prevalence of acute respiratory infections and diarrhoea among sub-Saharan African children. It also examined if there was any significant morbidity benefit conferred by three doses of diphtheria-tetanus-pertussis containing vaccines (DTP3) with respect to maternal HIV status. Data were obtained from the Demographic and Health Survey (DHS) program, United Nations Development Programs, World Bank and Joint United Nations Programme on HIV/AIDS. Pooled odds ratio (OR) and 95% confidence intervals (CI) were calculated for the countries. Test of heterogeneity, sensitivity analyses and meta-regression were also conducted. The prevalence of acute respiratory infections and diarrhoea were similar between the children that were vaccinated and those who were not vaccinated with DTP3. The pooled result shows that children who did not receive DTP3 were more likely to have symptoms of acute respiratory infections than children who had DTP3 (OR 1.09, 95% CI 1.02 to 1.17); with low heterogeneity across the countries. The combined result for diarrhoea shows that children who did not receive DTP3 were less likely to have episodes of diarrhoea than children who received DTP3 (OR 0.83, 95% CI 0.74 to 0.92); with substantial heterogeneity across the countries. There was no difference between the estimates of DTP3 vaccinated and unvaccinated children of HIV seropositive mothers with respect to symptoms of acute respiratory infections or episodes of diarrhoea. Tackling various causes and risk factors for respiratory tract infections and diarrhoeal diseases should be a priority for various stakeholders in sub-Saharan Africa.

Keywords: Acute respiratory infections; HIV; demographic and health surveys; diarrhoea; sub-Saharan Africa.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara
  • Child
  • Child, Preschool
  • Communicable Diseases / epidemiology*
  • Facilities and Services Utilization*
  • Female
  • HIV Infections*
  • Health Surveys
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Morbidity
  • Mothers*
  • Pregnancy
  • Prevalence
  • Vaccination / statistics & numerical data*
  • Vaccines / administration & dosage*
  • Young Adult


  • Vaccines

Grants and funding

Olatunji O. Adetokunboh and Charles S. Wiysonge are supported by the National Research Foundation of South Africa (Grant numbers: 106035 and 108571) and the South African Medical Research Council. Olalekan A. Uthman is supported by the National Institute of Health Research using Official Development Assistance funding. The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, National Institute for Health Research; National Research Foundation of South Africa; National Institute of Health Research; South African Medical Research Council; South African Medical Research Council.