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Neonatal Bacille Ca...
Neonatal Bacille Calmette-Guérin vaccination and tuberculin skin test reactions at 2- and 6-months : Effects on mortality up to 1 year of age
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- Schaltz-Buchholzer, Frederik (författare)
- University of Southern Denmark,Bandim Health Project
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- Roth, Adam (författare)
- Lund University,Lunds universitet,Klinisk mikrobiologi, Malmö,Forskargrupper vid Lunds universitet,Clinical Microbiology, Malmö,Lund University Research Groups,Bandim Health Project,Public Health Agency of Sweden
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- de Bree, L. Charlotte J. (författare)
- University of Southern Denmark,Radboud University Medical Center
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- Biering-Sørensen, Sofie (författare)
- Bandim Health Project
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- Timmermann, Clara Amalie Gade (författare)
- University of Southern Denmark,University of Copenhagen
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- Monteiro, Ivan (författare)
- Bandim Health Project
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- Aaby, Peter (författare)
- Bandim Health Project
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- Benn, Christine Stabell (författare)
- Bandim Health Project,University of Southern Denmark
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(creator_code:org_t)
- Elsevier BV, 2021
- 2021
- Engelska.
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Ingår i: Vaccine. - : Elsevier BV. - 0264-410X. ; 39:50, s. 7286-7294
- Relaterad länk:
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http://dx.doi.org/10... (free)
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https://doi.org/10.1...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: In randomized trials, Bacille Calmette-Guérin (BCG) vaccine has been associated with reduced all-cause mortality. BCG-induced Tuberculin Skin Test (TST) reactions have also been associated with reduced all-cause mortality. We aimed to assess the association between TST responses and subsequent mortality in three birth cohorts and conducted a meta-analysis of existing studies. Methods: Observational study within three Guinea-Bissau BCG trial birth cohorts (conducted 2002–04, 2009–2013 and 2014–18) that encompassed children who were BCG-vaccinated within 28 days with TSTs performed at 2- (n = 1389) and 6-months (n = 2635) of age. We evaluated TST reaction determinants by binomial regression and assessed the association between TSTs > 1 mm (reactors) vs. ≤ 1 mm (non-reactors) and subsequent mortality risk up to age 12 months in Cox-models providing Mortality Rate Ratios (MRRs). We searched PubMed for studies to calculate meta-estimates of the association between TST reactivity by age 2- and 6-months and all-cause mortality. Results: Large post-vaccination wheal size was associated with 6-month TST positivity and so was receiving BCG-Denmark or BCG-Japan, compared with BCG-Russia. By age 2 months, 22% (302/1389) of infants were TST reactors with a 2–12-month mortality risk of 1.7% (5/302) vs. 3.3% (36/1087) for non-reactors, the corresponding reactor/non-reactor MRR = 0.49 (0.19–1.26). By age 6 months, 44% (1149/2635) of infants were reactors and the 6–12-month mortality risk was 0.4% (4/1149) vs. 0.6% (9/1486) for non-reactors, the MRR = 0.87 (0.27–2.86). The literature search provided 3 studies. The meta-analysis revealed a uniform pattern of reduced mortality associated with TST reactivity, a TST response by 2 months being associated with an MRR of 0.59 (0.39–0.90); for 6-month TST responses the MRR was 0.65 (0.43–1.00). Conclusion: Among BCG-vaccinated infants, TST reactions were associated with markedly reduced mortality. Improved vaccination technique and using certain BCG strains could lead to a higher TST reaction prevalence, which would enhance BCG's beneficial non-specific effects.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
Nyckelord
- Bacille Calmette-Guérin (BCG)
- Heterologous effects of vaccines
- Infant mortality
- Mantoux reaction
- Non-specific effects of vaccines
- Purified Protein Derivative (PPD)
- Tuberculin Skin Test (TST)
Publikations- och innehållstyp
- art (ämneskategori)
- ref (ämneskategori)
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