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Case-control study on evaluation of BCG vaccination of newborn in Rangoon, Burma
Insights
BCG vaccination in newborns offers 38% protection against tuberculosis in children. Its effectiveness varies by TB form and wanes over time, but significantly reduces deaths and health costs.
Area of Science:
- Pediatrics
- Infectious Diseases
- Public Health
Background:
- Tuberculosis remains a significant global health challenge, particularly in young children.
- Bacille Calmette-Guérin (BCG) vaccination is the primary method for preventing severe forms of childhood tuberculosis.
- Evaluating the real-world effectiveness of newborn BCG vaccination programs is crucial for public health policy.
Purpose of the Study:
- To assess the effectiveness of newborn BCG vaccination against tuberculosis in children under 5 years of age.
- To determine the protective efficacy of BCG vaccination for different forms of tuberculosis.
- To analyze the impact of BCG vaccination on mortality, neurological sequelae, and healthcare costs.
Main Methods:
- A case-control study design was employed.
- 311 children with tuberculosis (cases) and 1536 non-tuberculous children (controls) were recruited.
- Participants were matched for age, sex, and residential sector; BCG vaccination status was recorded.
Main Results:
- Newborn BCG vaccination demonstrated 38% overall protection against all forms of tuberculosis.
- Protective efficacy varied by tuberculosis type: 20% for primary complex, 52% for tuberculous meningitis, and 80% for disseminated tuberculosis.
- The protective effect was strongest in the first 3 years post-vaccination, diminishing thereafter.
Conclusions:
- Newborn BCG vaccination provides significant, albeit variable, protection against childhood tuberculosis.
- Despite waning efficacy over time, BCG vaccination substantially reduces tuberculosis-related deaths, neurological complications, and healthcare expenditures.
- The findings underscore the considerable public health impact of BCG vaccination programs, even with moderate overall efficacy.
Abstract:
A case-control study was carried out on 311 tuberculous children under 5 years of age and 1536 non-tuberculous controls, matched for age, sex and the sector of residence, to evaluate the effectiveness of BCG vaccination of newborns in Rangoon, Burma. BCG vaccination status of both the cases and their matched controls was recorded. BCG vaccination in the newborn conferred 38% protection against the sum total of all forms of tuberculosis. The protective efficacy varied with the different forms of tuberculosis. It was only 20% for primary complex and 52% and 80% for tuberculous meningitis and disseminated tuberculosis, respectively. The protective effect of BCG vaccination was highest during the first 3 years after vaccination and then waned during the subsequent years. Although the protective efficacy seemed to be low, the impact of a BCG vaccination programme on the preventable deaths, neurological sequelae and the health services expenses is considerable.