Effectiveness of bacillus calmette guerin (BCG) vaccination in the prevention of leprosy: A case control study in Nagpur, India

Zodpey, Sanjay; Shrikhande, Sunanda; Salodkar, Atul; Maldhure, B. R.; Kulkarni, Shyam W

doi:10.1016/s0895-4356(98)90054-3

Cited by 14 publications

(19 citation statements)

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“…Third, we did not have vaccination records for the participants in this study but instead compared those with and without scarring. This is consistent with most published studies on BCG vaccine efficacy; BCG vaccination scarring routinely is equated with effective BCG vaccination (2,7,18,29,33,(36)(37)(38). BCG vaccination scarring is related to TST reactivity, although the strength of this association varies among studies (4,6,(26)(27)(28)30; World Health Organization Expert Committee on Biological Stan- .…”

Section: Discussionsupporting

confidence: 85%

“…In studies of vaccine prevalence and/or efficacy, the presence or absence of a BCG vaccine scar routinely is used as a surrogate indicator of vaccination status, in place of or in addition to vaccination records (2,7,18,29,33,(36)(37)(38). Although not every immunized person scars, scarring occurs in most vaccinated individuals (12,20) and is a stable phenomenon (11).…”

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confidence: 99%

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Clinical and Immune Impact of Mycobacterium bovis BCG Vaccination Scarring

Jason¹,

Archibald

Nwanyanwu

et al. 2002

Infect Immun

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The World Health Organization recommends Mycobacterium bovis BCG vaccination in areas of high tuberculosis prevalence. BCG's clinical and immune effects, not necessarily Mycobacterium tuberculosis specific, are unclear. BCG vaccine scarring often is used as a surrogate marker of vaccination or of effective vaccination. We evaluated BCG scarring status in relation to clinical findings and outcome in 700 hospitalized Malawians, of whom 32 had M. tuberculosis bloodstream infections (BSI) (10 of whom had cellular immune studies done) and of whom 48 were infants <6 months old and therefore recently vaccinated (19 of whom had immune studies). In the patients >6 months old, scarring was not related to the presence of pulmonary symptoms (35 versus 30%), chronic cough or fever, mortality, or M. tuberculosis BSI. In M. tuberculosis BSI patients, scarring was unrelated to mortality, vital signs, or clinical symptoms but those with scarring had higher proportions of memory and activated T cells and more type 2-skewed cytokine profiles. Infants with either BCG scarring (n ‫؍‬ 10) or BCG lesional inflammation (n ‫؍‬ 5) had no symptoms of sepsis, but 18 of 33 infants without BCG vaccination lesions did. Those with BCG lesions had localized infections more often than did those without BCG lesions. These infants also had lower median percentages of lymphocytes spontaneously making interleukin-4 (IL-4) or tumor necrosis factor alpha (TNF-␣) and lower ratios of T cells spontaneously making IL-4 to T cells making IL-6. Thus, we found that, in older patients, BCG vaccine scarring was not associated with M. tuberculosis-specific or nonspecific clinical protection. Those with M. tuberculosis BSI and scarring had immune findings suggesting previous M. tuberculosis antigen exposure and induction of a type 2 cytokine pattern with acute reexposure. It is unlikely that this type 2 pattern would be protective against mycobacteria, which require a type 1 response for effective containment. In infants <6 months old, recent BCG vaccination was associated with a non-M. tuberculosis-specific, anti-inflammatory cytokine profile. That the vaccinated infants had a greater frequency of localized infections and lesser frequency of sepsis symptoms suggests that this postvaccination cytokine pattern may provide some non-M. tuberculosis-specific clinical benefits.

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Section: Discussionsupporting

confidence: 85%

mentioning

confidence: 99%

Clinical and Immune Impact of Mycobacterium bovis BCG Vaccination Scarring

Jason¹,

Archibald

Nwanyanwu

et al. 2002

Infect Immun

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“…Currently, BCG vaccination covers 85% of newborn infants, and it has been estimated that nearly 100 million children are vaccinated with BCG vaccine every year (12). Several studies have shown that BCG protects against TBM and that its efficacy is around 75 to 85% (8,18,27,34,105,129,163,188,194,212,244,248). Two recent meta-analyses also concluded that BCG vaccination protects against TBM (39,175).…”

Section: Preventionmentioning

confidence: 99%

Central Nervous System Tuberculosis: Pathogenesis and Clinical Aspects

et al. 2008

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SUMMARY Tuberculosis of the central nervous system (CNS) is a highly devastating form of tuberculosis, which, even in the setting of appropriate antitubercular therapy, leads to unacceptable levels of morbidity and mortality. Despite the development of promising molecular diagnostic techniques, diagnosis of CNS tuberculosis relies largely on microbiological methods that are insensitive, and as such, CNS tuberculosis remains a formidable diagnostic challenge. Insights into the basic neuropathogenesis of Mycobacterium tuberculosis and the development of an appropriate animal model are desperately needed. The optimal regimen and length of treatment are largely unknown, and with the rising incidence of multidrug-resistant strains of M. tuberculosis, the development of well-tolerated and effective antibiotics remains a continued need. While the most widely used vaccine in the world largely targets this manifestation of tuberculosis, the BCG vaccine has not fulfilled the promise of eliminating CNS tuberculosis. We put forth this review to highlight the current understanding of the neuropathogenesis of M. tuberculosis, to discuss certain epidemiological, clinical, diagnostic, and therapeutic aspects of CNS tuberculosis, and also to underscore the many unmet needs in this important field.

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“…They share common antigens as evidenced by conversion of lepromin intradermal tests after the administration of Bacille-Calmette-Guerin (BCG) and the partial protection offered by BCG against leprosy [23]. Though an increased frequency of pulmonary tuberculosis in patients with lepromatous leprosy may occur as a result of malnutrition, tuberculosis occurs across the spectrum of leprosy [20].…”

Section: Discussionmentioning

confidence: 99%

Co-Infection with M. tuberculosis and M. leprae-Case Report and Systematic Review

Srinivas¹,

Devaraj²,

Aithal³

2013

Mycobact Diseases

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SummaryThe relationship between M. tuberculosis and M. leprae remains enigmatic with evidence to support relative protection to predisposition cited in the literature. With the near eradication of M. leprae, recognition of new cases may be delayed with poor outcomes. We describe a case of drug-resistant extra-pulmonary tuberculosis co-infection with tuberculoid leprosy. We also discuss the findings of our comprehensive literature review on clinical features, treatment and outcomes of dual infections. We hope that this manuscript serves as a timely reminder and ready reckoner of findings of this rare situation. AbstractBackground: Co-infection with Mycobacterium tuberculosis and M. leprae is infrequent and conflicting views on their interaction exist.

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Effectiveness of bacillus calmette guerin (BCG) vaccination in the prevention of leprosy: A case control study in Nagpur, India

Cited by 14 publications

References 0 publications

Clinical and Immune Impact of Mycobacterium bovis BCG Vaccination Scarring

Clinical and Immune Impact of Mycobacterium bovis BCG Vaccination Scarring

Central Nervous System Tuberculosis: Pathogenesis and Clinical Aspects

Co-Infection with M. tuberculosis and M. leprae-Case Report and Systematic Review

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