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BCG revaccination and tuberculin reactivity.

N Kuyucu1, S Kuyucu, A Bakirtas

  • 1Dr. Sami Ulus Children's Hospital, Telsizler, Ankara, Turkey. nkuyucu@yahoo.com

Indian Journal of Pediatrics
|March 10, 2001
PubMed
Summary

The number of BCG vaccines and scars impacts tuberculin reactivity in children. Indurations over 15 mm in high-prevalence areas warrant tuberculosis investigation, not just BCG assessment.

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Area of Science:

  • Pediatrics
  • Immunology
  • Infectious Diseases

Background:

  • Tuberculin reaction interpretation in revaccinated children is debated.
  • The influence of Bacillus Calmette-Guérin (BCG) vaccination schedules on tuberculin skin test (TST) reactivity requires clarification.

Purpose of the Study:

  • To evaluate the effect of BCG vaccination number and scar concordance on tuberculin reactivity in children aged 7-14 years.
  • To determine appropriate TST interpretation criteria in settings with high tuberculosis prevalence and routine BCG revaccination.

Main Methods:

  • Purified protein derivative (PPD) testing was performed on 2810 healthy children.
  • Children were stratified into four groups based on age (7-10 and 11-14 years) and concordance between vaccination records/scars.
  • Tuberculin induration sizes were measured and analyzed in relation to vaccination history and time elapsed since the last dose.

Main Results:

  • Mean induration sizes varied across groups, ranging from 8.0 mm to 10.9 mm.
  • In groups with non-concordant vaccination/scar numbers, induration size decreased with increased time post-vaccination.
  • In groups with concordant vaccination/scar numbers, induration size positively correlated with time post-vaccination.

Conclusions:

  • BCG revaccination policies and time since vaccination influence TST results.
  • An induration size of >= 15 mm should prompt further investigation for active tuberculosis in high-prevalence areas, rather than solely attributing it to BCG vaccination.

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