BCG scar, socioeconomic and nutritional status: a study of newborns in urban area of Makassar, Indonesia

Abstract

SummaryObjectiveTo investigate factors that determine the response to Bacille Calmette–Guérin (BCG) vaccination in urban environments with respect to socioeconomic status (SES), prenatal exposure to infections or newborn's nutritional status.MethodsThe study was conducted in an urban area, in Makassar, Indonesia. At baseline, 100 mother and newborns pair from high and low SES communities were included. Intestinal protozoa, soil transmitted helminths, total IgE, anti‐Hepatitis A Virus IgG and anti‐Toxoplasma IgG were measured to determine exposure to infections. Information on gestational age, birth weight/height and delivery status were collected. Weight‐for‐length z‐score, a proxy for newborns adiposity, was calculated. Leptin and adiponectin from cord sera were also measured. At 10 months of age, BCG scar size was measured from 59 infants. Statistical modelling was performed using multiple linear regression.ResultsBoth SES and birth nutritional status shape the response towards BCG vaccination at 10 months of age. Infants born to low SES families have smaller BCG scar size compared to infants born from high SES families and total IgE contributed to the reduced scar size. On the other hand, infants born with better nutritional status were found to have bigger BCG scar size but this association was abolished by leptin levels at birth.ConclusionThis study provides new insights into the importance of SES and leptin levels at birth on the development of BCG scar in 10 months old infants.

The relationship between BCG scar size and socioeconomic status on the severity and mortality of COVID-19 patients, “as indicators of the immunity”

“…Some indicated that low SES is associated with small scar size. 12 In this study the reverse is true. Where the higher severity and mortality were associated with high socioeconomic status and small size BCG scar.…”

“…The SES is mainly detected by several variables where occupation, income and education are important determinants. 12…”

The correlation of Foxp3 + gene and regulatory T cells with scar BCG formation among children with Tuberculosis

“…However, scars may be present or not after the BCG vaccine. Scars may be absent due to administrating lower doses of vaccine in childhood, the difficulty of injecting the entire amount of vaccine and the relatively weak local immune response in young children, or the probability that they may even disappear with time [5] , [6] , [7] .…”

Factors Associated with BCG Scar of Pediatric Tuberculosis Patients at Pisangan and East Ciputat Community Health Centers

“…33 The results of this study are in line with previous studies, which stated that gender and nutritional status of children were not associated with BCG scars. 34 In the study of Amaruddin et al (2019), it was shown that there was a significant relationship between socioeconomic status and the nutritional status of infants at birth with BCG scars after controlling for leptin levels. 35 BCG scars are a sign of better survival among children in countries with high child mortality.…”

“…34 In the study of Amaruddin et al (2019), it was shown that there was a significant relationship between socioeconomic status and the nutritional status of infants at birth with BCG scars after controlling for leptin levels. 35 BCG scars are a sign of better survival among children in countries with high child mortality. BCG vaccination could affect the response to several major infections, one of that also includes malaria.…”