The results of this cohort-controlled trial support the findings of the previous Hungarian RCT. The primary prevention of some major structural birth defects by multivitamins containing folic acid or by folic acid has great public health importance.
There were no differences in the rate and distribution of disorders including allergies (except otitis media), ophthalmological and audiological anomalies, anthropometric and mental development between children who belonged to the multivitamin or to the trace element group.
Background
Measles incidence and mortality rates have significantly decreased since vaccine introduction. Despite this progress, however, there has been a global resurgence of measles. To understand the current global epidemiology, we analyzed measles surveillance data.
Methods
We analyzed data on measles cases from 2013–2018 reported to the World Health Organization. Univariate analysis was undertaken based on age, vaccination history, onset year, World Health Organization region, and World Bank income status for the country where the case was reported, and a surrogate indicator of the historical strength of the country’s immunization program. Annual incidence and a 2013–2018 mean country incidence per million were calculated.
Results
From 2013 through 2018, there were 899 800 reported measles cases, of which 57% occurred unvaccinated or undervaccinated persons, with an unknown vaccination history in another 30%. Lower-middle-income countries accounted for 66% of cases, 23% occurred in persons ≥15 years of age. In countries with stronger historical vaccination programs and higher country income, case patients had higher median ages.
Conclusions
Although most measles case patients are <15 years of age, an age shift is seen in countries with a higher income or a stronger historical vaccination program. Countries must strengthen immunization programs to achieve high vaccination coverage; some must undertake strategies to reach persons ≥15 years of age and close immunity gaps.
The effect of periconceptional multivitamin supplementation on postnatal development was studied in a randomised controlled trial comparing the use of a multivitamin tablet (Elevit Pronatal) with a tablet containing trace elements as part of the Hungarian Optimal Family Planning Programme. Of 4122 liveborn infants, 3356 were examined after the eighth month of life and medical records were obtained for a further 357; thus the total number of infants evaluated was 3713 (90/1%). The mortality was not significantly different between the groups receiving the multivitamins (9-6/1000) and trace elements (7.1/1000). There was no significant difference in the rates of serious or chronic disorders between the study groups except for atopic dermatitis, which was reported more often in the group receiving multivitamins (15 v four cases). Somatic development (body weight, body length, and head circumference) did not show a significant difference between the two groups. Mental and behavioural development was also similar in the two groups.
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