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A hospital-based survey of BCG coverage in Santo Domingo, the Dominican Republic
M A Espinal1, J Cruz Bello, E N Pérez
1CENISMI, Miami, FL 33166.
Insights
BCG vaccination coverage in the Dominican Republic is suboptimal, with many children lacking protection against tuberculosis. Strengthening the Bacillus Calmette-Guérin vaccination program is crucial to reduce disease risk.
Area of Science:
- Pediatrics
- Public Health
- Epidemiology
Background:
- Bacillus Calmette-Guérin (BCG) vaccination is a key strategy for tuberculosis prevention in children.
- Assessing vaccination coverage and associated factors is essential for program evaluation and improvement.
Purpose of the Study:
- To evaluate BCG vaccination coverage among children attending a hospital clinic in Santo Domingo.
- To identify factors influencing BCG vaccination status in the study population.
Main Methods:
- A cross-sectional study involving 2,000 pediatric patients was conducted.
- Data were collected via interviews with guardians and physical examination for BCG scars.
- Multivariate logistic regression analysis was used to identify predictors of BCG scar presence.
Main Results:
- Overall BCG vaccination coverage was reported as 68.3%, with 67.7% having a BCG scar.
- A history of immunization was the strongest predictor of BCG scar presence (OR = 6.29).
- Residence in Santo Domingo, patient age, and guardian education also influenced scar presence.
Conclusions:
- The BCG vaccination program in the Dominican Republic requires enhancement to ensure adequate coverage.
- A significant proportion of children are not receiving the protective benefits of BCG vaccination, increasing their risk of tuberculosis.
- Study findings highlight the need for targeted interventions to improve BCG uptake.
Abstract:
A cross-sectional study was conducted in April-June 1992 at the outpatient clinic of the Robert Reid Children's Hospital in Santo Domingo to assess BCG vaccination coverage and factors affecting BCG vaccination of children. A consecutive sample of 2,000 patients under 18 years of age was included in the study. The person accompanying the patient to the hospital was interviewed, using a standardized questionnaire, and both of the patient's arms were examined for the presence of a BCG scar. Overall, 67.7% of the participants were found to have the scar and 68.3% were said to have received a BCG vaccination. However, only 80.8% of those with the scar were said to have been vaccinated. Multivariate logistic regression analysis found that residence in Santo Domingo, the subject's age, and the education of the subject's legal guardian were all significant predictors of the scar's presence, but that the strongest predictor was a history of immunization (OR = 6.29, 95% CI = 5.01, 7.89). Despite various limitations of this study, the results support other data indicating that the BCG vaccination program in the Dominican Republic needs to be strengthened. While the situation may be no worse than that found in a number of other Latin American countries, it appears that many Dominican children are not benefiting from the preventive effect of BCG vaccination and are therefore running an unnecessarily high risk of contracting tuberculosis.