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[Tuberculosis in young children not vaccinated with BCG]
Insights
Infants unvaccinated or improperly vaccinated against tuberculosis (TB) face severe complications. Improved immunoprophylaxis is crucial for preventing infant TB, particularly acute forms.
Area of Science:
- Pediatrics
- Infectious Diseases
- Immunology
Background:
- Tuberculosis (TB) remains a significant threat to infants worldwide.
- BCG vaccination is a primary method for TB immunoprophylaxis in newborns.
- The effectiveness of BCG vaccination in infants requires ongoing evaluation.
Observation:
- A study analyzed 168 infants aged 3 months to 3 years with tuberculosis.
- 32.7% of infants were unvaccinated, and 67.3% had improper BCG vaccination (no postvaccinal skin signs).
- Local TB presented with complications in 58.9% of infants.
Findings:
- Infants with improper or no BCG vaccination showed significantly higher rates of complicated TB.
- Complications included dissemination to lungs/organs (44.4%), bronchopulmonary lesions (42.4%), and lung tissue destruction (18.2%).
- Acute TB, including tuberculous meningitis and miliary TB, occurred in 75-100% of unvaccinated infants.
Implications:
- Inadequate BCG vaccination in infants leads to severe TB manifestations and complications.
- There is a critical need to develop and enhance TB immunoprophylaxis strategies for newborns.
- Strengthening BCG vaccination programs is essential for reducing infant mortality and morbidity from TB.
Abstract:
Manifestations of tuberculosis infection were studied in 168 infants aged 3 months to 3 years of whom 32.7% had not been given BCG vaccine at birth and 67.3% received improper vaccination (the postvaccinal skin signs were absent in all patients). In 58.9% of the infants, local tuberculosis ran along with complications: dissemination into the lungs and other organs were detected in 44.4%, bronchopulmonary lesions in 42.4%, destruction of lung tissue in 18.2% and tuberculous extrapulmonary lesions in 28.3% of the infants. Specific changes were located in several organs in 9.1%. Tuberculosis of the intrathoracic lymph nodes and primary tuberculosis complex had a complicated course 2.2 times and 3.2 times more frequently, respectively, in BCG unvaccinated than in vaccinated infants. Acute tuberculosis (tuberculous meningitis, miliary and progressive tuberculosis with fatal outcome) in infancy is common in 75-100% of the unvaccinated children. Hence immunoprophylaxis of tuberculosis in newborns must be developed and improved.