Using real-life data to model the impact of increasing BCG vaccination coverage and scar prevalence on all-cause infant mortality.
BCG vaccine/administration and dosage
Child mortality
Guinea-Bissau/epidemiology
Public health
Scar/epidemiology
Tuberculosis/prevention and control
Vaccination
Vaccination coverage
Journal
Annals of epidemiology
ISSN: 1873-2585
Titre abrégé: Ann Epidemiol
Pays: United States
ID NLM: 9100013
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
14
12
2022
revised:
22
04
2023
accepted:
17
07
2023
medline:
29
9
2023
pubmed:
22
7
2023
entrez:
21
7
2023
Statut:
ppublish
Résumé
Estimating the potential impact on infant mortality of increasing Bacille Calmette-Guérin (BCG) vaccination coverage and BCG scar prevalence. Guinea-Bissau Health and Demographic Surveillance System data on BCG vaccination coverage, scar status, and all-cause mortality were used for this study. Mortality risk (MR) by scar status was assessed in Cox models providing adjusted mortality rate ratios (aMRRs). Distributions were fitted for survival, vaccination coverage, and scar prevalence. Models for 12-month mortality were calculated. We utilized World Bank data on birth rates and mortality rates to assess the potential global impact of optimizing BCG vaccination programs. BCG coverage was 81% and scar prevalence 42% among 2-month-old infants, and the 1- to 12-month scar/no scar aMRR was 0.40 (0.22, 0.76). Modeling 2-month 99% vaccination coverage with 95% developing scars would change the 1- to 12-month MR by -8% (-21%, +12%). Globally, the reduction in the MR between 1- and 12-month would be -14% (-14%, -15%), corresponding to -208,075 (-214,453, -204,023) fewer infant deaths/year. We confirmed previous observations: having a BCG scar markedly reduces infant MR. Increasing current global 2-month BCG vaccination coverage from 76% to 99%, and scar prevalence among vaccinated infants from 52% to 95% might reduce global infant mortality by >200,000 deaths/year. Thus, optimizing BCG vaccination programs to focus on increasing early BCG vaccination coverage and the overall scar prevalence would have major public health benefits.
Identifiants
pubmed: 37479121
pii: S1047-2797(23)00150-3
doi: 10.1016/j.annepidem.2023.07.007
pii:
doi:
Substances chimiques
BCG Vaccine
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
90-97.e7Informations de copyright
Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Sarah W. Stougaard reports financial support was provided by Knud Højgaards Fond. Sarah W. Stougaard also reports financial support was provided by Augustinus Fonden.