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BCG vaccination in malnourished child population
P Bhaskaram1, P Hemalatha, K V Rao
1National Institute of Nutrition, Indian Council of Medical Research, Jamia Osmania, Hyderabad.
Insights
Bacille Calmette-Guérin (BCG) vaccination helps localize tuberculosis lesions in children, regardless of nutritional status. Data do not support routine BCG revaccination in infants.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- The effectiveness of Bacille Calmette-Guérin (BCG) vaccination against tuberculosis remains debated.
- Understanding BCG's protective role, especially concerning nutritional status and revaccination, is crucial for public health strategies.
Purpose of the Study:
- To investigate the protective effect of BCG vaccination in preschool children with tuberculosis.
- To assess the influence of nutritional status on BCG efficacy.
- To evaluate the need for BCG revaccination in children.
Main Methods:
- A cohort study involving 504 preschool children diagnosed with tuberculosis.
- Comparison of disease progression and lesion localization between BCG-vaccinated and unvaccinated children.
- Analysis of vaccination effects considering nutritional status and age.
Main Results:
- BCG-vaccinated children demonstrated a significantly higher tendency for localized tubercular lesions compared to unvaccinated children, who often presented with progressive disease.
- The protective effect of BCG vaccination was observed irrespective of the child's nutritional status.
- While age did not influence disease severity in unvaccinated children, older vaccinated children (over 3 years) showed better lesion localization.
Conclusions:
- BCG vaccination appears to play a protective role by promoting localized tuberculosis lesions in children.
- Nutritional status does not negate the benefits of BCG vaccination.
- Current evidence does not support the administration of a booster dose of BCG vaccine to children previously vaccinated in infancy.
Abstract:
The efficacy of BCG vaccination is still a subject of controversy. In the present study the protective role of BCG vaccination, the influence of nutritional status and justification for revaccination in children were investigated. Of the 504 preschool children suffering from tuberculosis who were registered for the study, 345 children did not receive BCG vaccine while the others had it during early infancy. Vaccinated children showed a significantly greater tendency to localise the tubercular lesions while most of the unvaccinated children suffered from progressive forms of the infection. Vaccination had similar effects even when there was associated malnutrition. Age did not seem to influence the severity of the disease in unvaccinated children while older children (greater than 3 yrs) had a greater tendency to localise the lesion in the vaccinated group. These data do not support the proposal of administering a booster dose of BCG to children who were vaccinated during early infancy.