Neonatal BCG vaccination and child survival in TB-exposed and TB-unexposed children: a prospective cohort study.
BCG Vaccine
Case-Control Studies
Cause of Death
Child Mortality
Child, Preschool
Female
Follow-Up Studies
Guinea-Bissau
/ epidemiology
Humans
Infant
Infant Mortality
Infant, Newborn
Male
Prospective Studies
Public Health Surveillance
Tuberculosis
/ diagnosis
Urban Health
/ statistics & numerical data
Vaccination Coverage
/ statistics & numerical data
epidemiology
paediatric infectious disease & immunisation
public health
tuberculosis
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
28 02 2020
28 02 2020
Historique:
entrez:
2
3
2020
pubmed:
3
3
2020
medline:
16
2
2021
Statut:
epublish
Résumé
To assess the association between neonatal BCG vaccination and mortality between 28 days and 3 years of age among tuberculosis (TB)-exposed and TB-unexposed children. Prospective cohort study. Bandim Health Project runs an urban Health and Demographic Surveillance site in Guinea-Bissau with registration of mortality, vaccination status and TB cases. Children entered the analysis when their vaccination card was inspected after 28 days of age and remained under surveillance to 3 years of age. Children residing in the same house as a TB case were classified as TB-exposed from 3 months prior to case registration to the end of follow-up. Using Cox-proportional hazards models with age as underlying time scale, we compared mortality of children with and without neonatal BCG between October 2003 and September 2017. HR for neonatal BCG compared with no neonatal BCG by TB-exposure status. Among the 39 421 children who entered the analyses, 3022 (8%) had observation time as TB-exposed. In total, 84% of children received neonatal BCG. Children with neonatal BCG had lower mortality both in TB-exposed (adjusted HR: 0.57 (0.26 to 1.27)) and in TB-unexposed children (HR: 0.57 (95% CI 0.47 to 0.69)) than children without neonatal BCG. Children exposed to TB had higher mortality than TB-unexposed children if they had not received neonatal BCG. Neonatal BCG vaccination was associated with lower mortality among both TB-exposed and TB-unexposed children, consistent with neonatal BCG vaccination having beneficial non-specific effects. Interventions to increase timely BCG vaccination are urgently warranted.
Identifiants
pubmed: 32114478
pii: bmjopen-2019-035595
doi: 10.1136/bmjopen-2019-035595
pmc: PMC7050365
doi:
Substances chimiques
BCG Vaccine
0
Types de publication
Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e035595Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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