TUBERCULOSIS IN BCG VACCINATED AND UNVACCINATED CHILDREN

Area of Science:

• Pediatrics
• Infectious Diseases
• Immunology

Background:

• Tuberculosis remains a significant global health challenge, particularly in preschool-aged children.
• The role of Bacillus Calmette-Guérin (BCG) vaccination and protein energy malnutrition (PEM) in pediatric tuberculosis pathogenesis requires further elucidation.

Purpose of the Study:

• To investigate the pattern of tuberculosis in BCG-vaccinated versus unvaccinated preschool children.
• To assess the influence of severe protein energy malnutrition on tuberculosis development and severity in this age group.

Main Methods:

• A non-randomized study of 100 preschool children with tuberculosis, divided into 50 BCG-vaccinated (Group A) and 50 unvaccinated (Group B).
• Assessment of tuberculosis patterns, including intrathoracic, serious, and disseminated forms.
• Evaluation of the prevalence of severe protein energy malnutrition in both groups.

Main Results:

• Higher rates of severe protein energy malnutrition were observed in unvaccinated children (52%) compared to vaccinated children (34%).
• Intrathoracic tuberculosis was prevalent in both groups (68% in Group A, 76% in Group B).
• Serious forms of tuberculosis (meningitis, miliary, disseminated) occurred in 24% of vaccinated and 22% of unvaccinated children, with no statistically significant difference, though morbidity was lower in the vaccinated group for severe forms.

Conclusions:

• BCG vaccination appears ineffective in preventing tuberculosis infection in preschool children but may aid in localizing the infection.
• Severe protein energy malnutrition is a significant contributing factor to tuberculosis development in BCG-vaccinated preschool children.
• While BCG may not prevent infection, it shows a trend towards reducing the severity of tuberculosis manifestations.