BCG vaccination is associated with decreased severity of tuberculosis in Pakistan (original) (raw)
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BCG vaccination and tuberculosis prevention: A forty years cohort study, Monastir, Tunisia
PLOS ONE, 2019
We aimed to describe incidence, trends of tuberculosis (TB) over 18 years and to evaluate the impact of the BCG vaccine after four decades of immunization program according to three protocols. We performed a cohort study including declared cases in Monastir from January 1, 2000 to December 31, 2017. We reported 997 cases of TB. The predominant site was pulmonarylocalization (n = 486). The age standardized incidence of pulmonary and lymph node TB per 100,000 inh were 5.71 and 2.57 respectively. Trends were negative for pulmonary TB (PTB) (b =-0.82; r =-0.67; p<10 −3) and positive for lymph node localization (b = 1.31; r = 0.63; p<10 −3). We had not notified cases of HIV associated with TB. Crude incidence rate (CIR) of PTB per 100,000 inh was 8.17 in Non-Vaccinated Cohort (NVC) and 2.85 in Vaccinated Cohort (VC) (p < 0.0001). Relative risk reduction (RRR) of BCG vaccination was 65.1% (95%CI:57.5;71.4) for pulmonary localization and 65% (95%CI:55; 73) for other localizations. We have not established a significant RRR of BCG vaccination on lymph node TB. Protocol 3 (at birth) had the highest effectiveness with a RRR of 96.7% (95%CI: 86.6%; 99.2%) and 86% (95%CI:71%;91%) in patients with PTB and other localizations TB respectively. In Cox regression model the HR was 0.061 (95% CI 0.015-0.247) for PTB and 0.395 (95% CI 0.185-0.844) for other localizations TB in patients receiving protocol 3 compared to NVC. For lymph-node TB, HR was 1.390 (95% CI 1.043-1.851) for protocol 1 and 1.849 (95% CI 1.232-2.774) for protocol 2 compared to NVC. Depending on the three protocols, the BCG vaccine had a positive impact on PTB and other TB localizations that must be kept and improved. However, protocols 1 and 2 had a reverse effect on lymph node TB.
The Importance Of Immunoprophylaxis For Tuberculosis (BCG Vaccination)
The American journal of medical sciences and pharmaceutical research, 2021
Vaccination is a costly activity, as it involves coverage of a wide population. Methods to assess the effectiveness of immunoprophylaxis and the quality of preventive (anti-epidemic) measures are discussed in this context.
Spectrum of childhood tuberculosis in BCG vaccinated and unvaccinated children
Medical Journal Armed Forces India, 2009
Background: Childhood tuberculosis remains a major public health problem in India. We evaluated the impact of BCG vaccination on childhood tuberculosis and the underlying risk factors. Methods: 100 consecutive children below 12 years diagnosed to have tuberculosis based on the WHO and IAP consensus statement were included in the study. Result: Majority(42%) of children with tuberculosis were below four years of age. History of contact with a case of tuberculosis was present in 41 cases. BCG scar was present in 77 cases indicating a poor coverage/uptake of BCG vaccination. Pulmonary form of tuberculosis was seen in 52 and extra pulmonary form in 41 cases. Tubercular lymphadenitis was seen in seven cases, of which more than 70 % were in BCG vaccinated group. There was no statistically significant difference in the type of tuberculosis (pulmonary or extra pulmonary) and BCG vaccination. In the extra pulmonary form, 13 children had neuro-tuberculosis, of which 66% were in BCG unvaccinated group, which was statistically significant (p=0.011). The underlying risk factors were poor socioeconomic status (62%), malnutrition (61%) and poor immunization coverage. Conclusion: Higher incidence of pulmonary tuberculosis in BCG vaccinated group was not statistically significant. However, high incidence of neuro-tuberculosis in BCG unvaccinated group was statistically significant. The underlying risk factors were poor socioeconomic status, malnutrition and poor immunization coverage and should be taken into consideration in order to prevent morbidity and mortality due to tuberculosis in children.
Protection by BCG Vaccine Against Tuberculosis: A Systematic Review of Randomized Controlled Trials
Clinical Infectious Diseases, 2014
This new systematic review and analysis suggests BCG vaccination in infancy or BCG vaccination when stringent tuberculin testing excludes those with a small degree of prior infection or sensitization to environmental mycobacteria protects against pulmonary diseases even in the tropics Abstract Background: Randomized trials assessing BCG vaccine protection against tuberculosis have widely varying results, for reasons that are not well understood.
Vaccination against Tuberculosis: Beyond BCG
Journal of Respiratory Diseases and Medicine, 2020
Tuberculosis (TB) continues to be a major health problem causing enormous morbidity worldwide despite introduction of effective and affordable chemotherapy more than 50 years ago. Among adults of most economically productive age groups and people affected with HIV TB, tuberculosis remains a leading killer, and even cured TB cases can be left with lifetime post TB sequelae, thus substantially reducing their quality of life. M. tuberculosis has shown extraordinary capabilities to subvert and resist bactericidal response of their infected host. These capabilities have enabled the bacillus to colonize about one third of the world's population of which 1.5 million people die annually. Further development of drug resistant strains poses a serious problem for the TB control programs. These alarming facts and figures call for an urgent concern to focus our efforts against tuberculosis. However, with the currently existing case finding and treatment policies, it seems far way to eliminate the deadly pathogen in near future. With many concentrated efforts to tackle this infection, we still look for the 'magic bullet' which can defeat this 'Captain of death'. There is a need for an effective vaccine to strengthen our fight in elimination of this challenging disease. Thus, the need of the situation is to tackle the disease through vaccination programme. For a nation of the size of India, therapy and prevention needs to go side by side to be able to achieve the ambitious goals of achieving tuberculosis elimination by 2025. Thus, in the present review an attempt has been made to review the status and efforts underway for vaccine development against tuberculosis and discussed the limitations of vaccines.
National Journal of Community Medicine, 2013
Introduction: BCG vaccine has shown consistently high efficacy against childhood tubercular meningitis and miliary tuberculosis and other mycobacterial diseases. It is considered to be a safe vaccine with a low incidence of adverse effects. Efficacy of BCG vaccine found in different clinical trials is variable in different geography. Objectives: Study was done to assess the efficacy of BCG vaccine. Materials and Methods: All the children who were less than three years of age and were previously BCG vaccinated and not-vaccinated, were included in this study. A total of sixty (60) vaccinated children and sixty non-vaccinated children were selected. These children were followed up prospectively for 24 months, at the end of which, it was seen whether they developed tuberculosis or not. Results: Out of these 60 children in both the cases and control groups, total number of BCG vaccinated children who developed TB were 4 (i.e. 6.6%) and total number of Non-BCG vaccinated children who developed TB were 12 (i.e. 20%). Thus, the efficacy of BCG vaccine calculated in our study was 67%. Conclusion: Most studies in different parts of the world have shown that the efficacy of BCG vaccine varies from zero to eighty percent. This study favors the efficacy of BCG vaccine. This vaccination strategy will be favorable for our children. Creation of awareness among the parents and family members for an early administration of BCG vaccine after child birth can be recommended.