Protective value of BCG vaccination in children in Bangkok, Thailand

Abstract

The protective effect of bacille Calmette-Guérin (BCG) vaccination against tuberculosis is controversial. In a study, 330 patients less than 12 years of age with tuberculosis, 52.1% of whom had had BCG vaccination, were compared with a control group of 1106 patients free of tuberculosis, 81% of whom had BCG vaccination. The occurrence of disseminated forms of tuberculosis, tuberculous meningitis, tuberculous peritonitis, and tuberculosis of bone and joints in BCG-vaccinated patients was quite low. With BCG vaccination, the incidence of the disseminated form of tuberculosis was significantly lower than that of pulmonary tuberculosis with pulmonary parenchymal lesions, primary pulmonary complexes, and pleural effusion. Tuberculous peritonitis was significantly less frequent than pulmonary tuberculosis with pulmonary parenchymal lesions, enlarged hilar glands, pulmonary primary complex, and pleural effusions. The study demonstrated that BCG gave an overall protective effect of 74% and that a major effect of this immunity was to produce a localized form of tuberculosis.

Central Nervous System Tuberculosis: Pathogenesis and Clinical Aspects

“…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).…”

Molecular Epidemiology and Drug Resistance of Tuberculous Meningitis

“…Thailand has included mass immunization with the BCG vaccine for every newborn as the national public health policy since 1970. In Thailand, 76% of the protective effect of BCG against TB has been previously demonstrated, and a significantly lower extrapulmonary TB rate compared to pulmonary TB has also been demonstrated (Chavalittamrong et al, 1986). However, clear evidence of BCG vaccine efficacy against TB and extrapulmonary TB by experimental study is still required.…”

“…For instance, in the Thai population, the most predominant ages of TBM patients are 31-45 years (35.3%), and only 12% of TBM patients are less than 15 years old (Yorsangsukkamol et al, 2009). With BCG vaccination, a significantly lower incidence of disseminated TB, such as TBM, was found in patients less than 12 years old compared to pulmonary TB (Chavalittamrong et al, 1986). The average ages of TBM patients in particular regions, even on different continents, are around 30 years higher (table 1).…”

“…Several studies have indicated the protective effects of the BCG vaccine against TBM (Awasthi and Moin, 1999;Puvacic et al, 2004;Mittal et al, 1996;Trunz et al, 2006;Xiong et al, 2009). A protective efficacy of approximately 60-70% for the BCG vaccine against TBM has been reported (Thilothammal et al, 1996;Chavalittamrong et al, 1986). The study compared clinical presentations between BCGvaccinated and unvaccinated children and revealed that vaccinated TBM patients showed better mentation and had superior disease outcomes (Kumar et al, 2005).…”

Lower-Lung-Field Tuberculosis in Saudi Arabia

“…Some have a positive history of tuberculosis in the family, though they may be free of tuberculosis. It is known that vaccination against tuberculosis does not ensure 100% protection [4].…”