BCG et nourrissons à risque de tuberculose : étude de couverture vaccinale à Marseille après la levée d’obligation

Danvin, C.; Bosdure, E.; Brémond, V.; Rousset‐Rouvière, Caroline; Loundou, D.-A.; Barreau-Baumstark, K.; Dubus, J.‐C.

doi:10.1016/j.arcped.2010.08.022

Cited by 6 publications

(4 citation statements)

References 9 publications

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“…This is particularly true if the high-risk groups recommended for vaccination under a targeted program are not effectively identified and subsequently vaccinated. This implication is particularly alarming considering that 3 studies reported subsequent incomplete vaccine coverage of high-risk groups following withdrawal of mass vaccination [14, 35, 60], (Table 4) highlighting potential negative implications of discontinuation of universal programs, and the need to improve strategies to identify and reach the selected at-risk groups when shifting to a targeted vaccination policy. Therefore, in cases where an existing vaccination program is discontinued, it is imperative that an effective TB surveillance system is in place and well established before the withdrawal of the program, and that case-finding, screening, and diagnostic efforts are strengthened in order to ensure continued TB control [19, 20].…”

Section: Discussionmentioning

confidence: 99%

A systematic review of BCG vaccination policies among high-risk groups in low TB-burden countries: implications for vaccination strategy in Canadian indigenous communities

Faust

Schreiber

Bocking³

2019

BMC Public Health

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BackgroundBacille Calmette-Guérin (BCG) vaccination against tuberculosis (TB) is widespread in high-TB-burden countries, however, BCG vaccination policies in low-burden countries vary. Considering the uncertainties surrounding BCG efficacy and the lower likelihood of TB exposure in low-incidence countries, most have discontinued mass vaccination, choosing instead a targeted vaccination strategy among high-risk groups. Given the increased risk of TB infection in Canadian Indigenous communities compared to the general Canadian population, these communities are a pertinent example of high-incidence groups in an otherwise low-burden country, warranting particular consideration regarding BCG vaccination strategy. This systematic review aims to synthesise and critically appraise the literature on BCG vaccination strategies in high-risk groups in low-incidence settings to provide policy considerations relevant to the Canadian Indigenous context.Methods: A literature search of the Medline and Embase databases was conducted, returning studies pertaining to BCG vaccine efficacy, TB incidence under specific vaccination policies, BCG-associated adverse events, and vaccination policy guidelines in low-burden countries. Study screening was tracked using the Covidence systematic review software (Veritas Health Innovation, Melbourne, Australia), and data pertaining to the above points of interest were extracted.ResultsThe final review included 49 studies, spanning 15 countries. Although almost all of these countries had implemented a form of mass or routine vaccination previously, 11 have since moved to targeted vaccination of selected risk groups, in most cases due to the low risk of infection among the general population and thus the high number of vaccinations needed to prevent one case in the context of low-incidence settings. Regarding identifying risk groups for targeted screening, community-based (rather than individual risk-factor-based) vaccination has been found to be beneficial in high-incidence communities within low-incidence countries, suggesting this approach may be beneficial in the Canadian Indigenous setting.ConclusionsCommunity-based vaccination of high-incidence communities may be beneficial in the Canadian Indigenous context, however, where BCG vaccination is implemented, delivery strategies and potential barriers to achieving adequate coverage in this setting should be considered. Where an existing vaccination program is discontinued, it is crucial that an effective TB surveillance system is in place, and that case-finding, screening, and diagnostic efforts are strengthened in order to ensure adequate TB control. This is particularly relevant in Canadian Indigenous and other remote or under-served communities, where barriers to surveillance, screening, and diagnosis persist.

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Section: Discussionmentioning

confidence: 99%

A systematic review of BCG vaccination policies among high-risk groups in low TB-burden countries: implications for vaccination strategy in Canadian indigenous communities

Faust

Schreiber

Bocking³

2019

BMC Public Health

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“…Cette étude, menée auprès d'enfants de moins de 5 ans consultant au SAUP d'un hôpital des quartiers défavorisés de Marseille confirme la CV des nourrissons à risque (73,9 %) observée dans un autre SAUP de la ville en 2009 [10]. De la même manière, la CV des enfants à risque nés à Marseille (85 %) se rapproche de celle observée dans la maternité de notre hôpital en 2007 (88 %) [11].…”

Section: Discussionunclassified

“…N'ont pas été inclus : les enfants non accompagnés d'un de leur parent ou tuteur légal, ceux nécessitant une prise en charge immédiate, ceux dont les parents ont refusé de répondre au questionnaire et ceux dont les parents ne pouvaient pas répondre au questionnaire à cause de la barrière de la langue. La taille de l'échantillon (134 enfants) avait été préalablement calculée en fonction de l'estimation de la proportion d'enfants à risque parmi les enfants venant consulter au SAUP (60 %) [10,11], de celle de la CV des enfants à risque nés après juillet 2007 (70 %) [10,11]…”

Section: Population éTudiéeunclassified

“…Elle était généralement plus élevée en Île-de-France qu'en province [9]. À Marseille, une étude menée en 2009 dans le service hospitalier d'accueil des urgences pédiatriques (SAUP) du centre-ville avait trouvé une CV de 74 % chez les nourrissons à risque [10]. L'hôpital Nord, situé dans des quartiers défavorisés à forte population d'origine étrangère, a mis en place en 2007 un programme de vaccination des nouveau-nés à risque dès la maternité.…”

Section: Introductionunclassified

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Vaccination par le BCG : enquête auprès d’enfants de moins de 5 ans consultant dans un service d’urgences hospitalières

Vernaz

Gaudart

Sallah

et al. 2014

Archives de Pédiatrie

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Couverture vaccinale et déterminants socioéconomiques de la vaccination BCG chez l’enfant avant 3 mois : résultats de la cohorte Elfe, 2011

Guthmann

Ragot

Boutieb

et al. 2016

Revue d'Épidémiologie et de Santé Publique

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BCG et nourrissons à risque de tuberculose : étude de couverture vaccinale à Marseille après la levée d’obligation

Cited by 6 publications

References 9 publications

A systematic review of BCG vaccination policies among high-risk groups in low TB-burden countries: implications for vaccination strategy in Canadian indigenous communities

A systematic review of BCG vaccination policies among high-risk groups in low TB-burden countries: implications for vaccination strategy in Canadian indigenous communities

Vaccination par le BCG : enquête auprès d’enfants de moins de 5 ans consultant dans un service d’urgences hospitalières

Couverture vaccinale et déterminants socioéconomiques de la vaccination BCG chez l’enfant avant 3 mois : résultats de la cohorte Elfe, 2011

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