Seasonal variation in the non-specific effects of BCG vaccination on neonatal mortality: three randomised controlled trials in Guinea-Bissau.
immunisation
malaria
maternal health
paediatrics
vaccines
Journal
BMJ global health
ISSN: 2059-7908
Titre abrégé: BMJ Glob Health
Pays: England
ID NLM: 101685275
Informations de publication
Date de publication:
2020
2020
Historique:
received:
27
07
2019
revised:
11
09
2019
accepted:
15
09
2019
entrez:
24
3
2020
pubmed:
24
3
2020
medline:
24
3
2020
Statut:
epublish
Résumé
The BCG vaccine protects non-specifically against other diseases than tuberculosis. Three randomised controlled trials of early BCG in Guinea-Bissau found a 38% reduction in all-cause neonatal mortality. Little is known about the underlying mechanisms. In Guinea-Bissau, prevalent infectious diseases display distinct seasonality. Revisiting the three trials (>6500 infants) comparing early BCG versus no early BCG in low weight infants on all-cause neonatal mortality over 12 consecutive years, we explored the seasonal variation in BCG's effect on mortality. In a subgroup of participants, adaptive and innate cytokine responses were measured 4 weeks after randomisation. Consistently over the course of the three trials and 12 years, the effect of BCG on all-cause neonatal mortality was particularly beneficial when administered in November to January, coincident with peaking malaria infections. During these months, BCG was also associated with stronger proinflammatory responses to heterologous challenge. Recent studies have suggested a protective effect of BCG against malaria. BCG may also ameliorate immune-compromising fatal effects of placental malaria in the newborn.
Identifiants
pubmed: 32201619
doi: 10.1136/bmjgh-2019-001873
pii: bmjgh-2019-001873
pmc: PMC7059430
doi:
Substances chimiques
BCG Vaccine
0
Banques de données
ClinicalTrials.gov
['NCT00146302', 'NCT00625482']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
e001873Commentaires et corrections
Type : CommentIn
Informations 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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