Scar formation and tuberculin conversion following BCG vaccination in infants: A prospective cohort study

Dhanawade, Sara; Kumbhar, Suhas G; Gore, Alka Dilip; Patil, Vijay N.

doi:10.4103/2249-4863.161327

Cited by 40 publications

(38 citation statements)

References 13 publications

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“…This is comparable to Dhanawade et al 13 who reported that the scar failure 8.6%. There were different reasons for scar failure such as weak vaccine, lost potency, and wrong technique.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of the Immune Response to Interferon Gamma Release Assay and Tuberculin Skin Test Among BCG Vaccinated Children in East of Egypt

Beshir

Zidan

El-Saadny³

et al. 2016

Medicine

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Bacille Calmette-Guérin vaccine (BCG) vaccination is used routinely in most of countries, especially developing one. The efficacy of the BCG vaccination generally decreases with time. The tuberculin skin test (TST) is a most popular diagnostic test for suspicion of tuberculosis (TB) in children till now, but it has many false positives. The interferon-gamma release assay (IGRA) is more specific than TST for detection of childhood TB, as it is more specific to Mycobacterium tuberculosis.Evaluate the interferon gamma response and TST reaction in BCG vaccinated children in east of Egypt.150 children were included in the study aged 1 month to 12 years; the collected data from the children included, full history taking, clinical examination, examination for the presence or absence of BCG scar under direct light. All the children had performed TST, IGRA.TST was done for all studied group reveal 51.3% with size of reaction <5 mm, 39.3% with size of reaction = 5 to 9 mm while 9.3% with size of reaction ≥10 mm. Mean size of reaction was 4.07 mm. Interferon gamma release assay was done for all studied group reveal 5 children (3.3%) with positive test. There was significant difference between the size of TST reaction and age (P < 0.01) with old children were more frequent to show positive reaction. Also, children with age range 1 month to 1 year were frequently have negative IGRA test, while children with age range 4 years to 12 years were frequently have positive test (P < 0.01). There was moderate agreement between IGRA and TST results (Kappa [κ] = 0.475). With high agreement between IGRA and TST results in children with absent BCG scar (κ = 1000).Therefore, Interferon gamma release assays have higher specificity and lower cross-reactions with BCG vaccination and nontuberculous Mycobacteraie than TST.

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“…This is comparable to Dhanawade et al 13 who reported that the scar failure 8.6%. There were different reasons for scar failure such as weak vaccine, lost potency, and wrong technique.…”

Section: Discussionsupporting

confidence: 87%

Evaluation of the Immune Response to Interferon Gamma Release Assay and Tuberculin Skin Test Among BCG Vaccinated Children in East of Egypt

Beshir

Zidan

El-Saadny³

et al. 2016

Medicine

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“…[5] It has been reported that the time interval between BCG vaccination and scar formation is commonly within 6 weeks,[67] although extreme cases up to 3 or more months have been documented. [89] Hence, the duration between the two BCG vaccinations received for the said child was inadequate for scar formation and therefore, the health worker who administered the second dose could only avoid such instances with a detailed history. However, it is possible that clients/patients from Angolan border communities claim to be nationals of Namibia to avoid paying fees for service rendered as people along the borders of both countries speak same local Kuangale language.…”

Section: Discussionmentioning

confidence: 99%

Dual Bacillus Calmette–Guerin vaccination along the border communities of Angola and Namibia

Umar¹,

Kabamba²

2016

J Family Med Prim Care

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Without a doubt, the synchronization of public health intervention on health issues along the international border will enhance the control of epidemic-prone disease and other health-related behavior. However, the lack of holistic planning and the involvement of the members of border communities could result in undesired health related events. This report advanced reasons that could have resulted in a child receiving two separate doses of Bacillus Calmette–Guerin vaccine within the first 4 days of life in two different health facilities. Finally, this report highlighted the need for proactive community participation and the need for consensus by experts on guidelines on how to deal with such cases particularly in the unfortunate event of adverse reactions.

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“…However, the only factors affecting scar response were weight at the time of vaccination and gender. Dhanawade et al reported that 64 out of 70 term infants exhibited a visible scar after 12 weeks of vaccination representing a scar failure rate of 8.6% (24). In preterms, BCG scar development was reported to be 69% and 90% (9,12).…”

Section: Discussionmentioning

confidence: 99%

Scar Formation and Tuberculin Skin Test Response After Bacillus Calmette-Guerin Vaccination: Does Prematurity or Low Birth Weight Have an Impact?

et al. 2017

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Objectives: The present study aimed at evaluating factors affecting scar formation and tuberculin skin test (TST) response in Bacillus Calmette-Guerin (BCG) vaccinated infants. Methods: In the current study, 216 infants with gestational age (GA) of 26 to 40 weeks and birth weight of 730 g to 4590 g were included. The mean corrected age was 6.27 ± 3.79 weeks, and the mean weight was 4442.4 ± 1084.1 g (range 2100 -7700 g) at the time of BCG vaccination. TST was applied at 8 to 16 weeks of vaccination. Factors affecting TST response and BCG scar formation were evaluated. Results: A scar response to BCG vaccination was found in 60%, 49.4%, and 59.7% of the infants with GA < 32 weeks, 33 to 36 weeks, and ≥ 37 weeks, respectively. Of the male infants 65% produced a scar compared to the 45% of the female infants (P = 0.014). The mean weight at the time of vaccination was significantly higher in infants with scar development than in those without scars (6976.94 g vs. 6455.68, P = 0.002). A tuberculin reaction was detected in 57% of the infants (80%, 54%, and 50% according to birth weight > 2500 g, 1500 -2500 g, and < 1500 g, respectively) (P = 0.213). TST response rate was 67%, 55%, and 47% according to GA ≥ 37 w, 33 -36 w, and ≤ 32 w, respectively (P = 0,020). In the present study, 68.4% of the cases with TST of 5 -10 mm, and 100% of the cases with TST > 10 mm developed scars ≥ 2 mm (r = 0.360; P = 0.001).Conclusions: Prematurity or birth weight does not affect BCG scar formation. TST response is lower in preterm babies. The correlation between scar formation and TST response was too low to be interpreted as positive.

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Scar formation and tuberculin conversion following BCG vaccination in infants: A prospective cohort study

Cited by 40 publications

References 13 publications

Evaluation of the Immune Response to Interferon Gamma Release Assay and Tuberculin Skin Test Among BCG Vaccinated Children in East of Egypt

Evaluation of the Immune Response to Interferon Gamma Release Assay and Tuberculin Skin Test Among BCG Vaccinated Children in East of Egypt

Dual Bacillus Calmette–Guerin vaccination along the border communities of Angola and Namibia

Scar Formation and Tuberculin Skin Test Response After Bacillus Calmette-Guerin Vaccination: Does Prematurity or Low Birth Weight Have an Impact?

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