Small Randomized Trial Among Low–birth-weight Children Receiving Bacillus Calmette-Guérin Vaccination at First Health Center Contact

Biering-Sørensen, Sofie; Aaby, Péter; Napirna, Bitiguida Mutna; Roth, Adam; Ravn, Henrik; Rodrigues, Amabélia; Whittle, Hilton; Benn, Christine Stabell

doi:10.1097/inf.0b013e3182458289

Cited by 220 publications

(229 citation statements)

References 4 publications

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“…78 Whereas in low birth weight neonates it reduced the mortality by almost 50% as demonstrated by fewer cases of sepsis and respiratory infections. 79,80 This is similar to results in adult mouse models of heterologous immunity where it was demonstrated that BCG-immune mice were more resistant to vaccinia virus infection and that this resistance was mediated by IFNg-producing CD4 T cells. 81 Interestingly, Steenhuis and others showed that in children, by 18 months of age, immunization with BCG resulted in lowered numbers of children with eczema, a Th2-immune mediated disease.…”

Section: Measles Vaccinesupporting

confidence: 68%

Vaccination and heterologous immunity: educating the immune system

Gil¹,

Kenney²,

Mishra³

et al. 2015

Transactions of the Royal Society of Tropical Medicine and Hygiene

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This review discusses three inter-related topics: (1) the immaturity of the neonatal and infant immune response; (2) heterologous immunity, where prior infection history with unrelated pathogens alters disease outcome resulting in either enhanced protective immunity or increased immunopathology to new infections, and (3) epidemiological human vaccine studies that demonstrate vaccines can have beneficial or detrimental effects on subsequent unrelated infections. The results from the epidemiological and heterologous immunity studies suggest that the immune system has tremendous plasticity and that each new infection or vaccine that an individual is exposed to during a lifetime will potentially alter the dynamics of their immune system. It also suggests that each new infection or vaccine that an infant receives is not only perturbing the immune system but is educating the immune system and laying down the foundation for all subsequent responses. This leads to the question, is there an optimum way to educate the immune system? Should this be taken into consideration in our vaccination protocols?

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Section: Measles Vaccinesupporting

confidence: 68%

Vaccination and heterologous immunity: educating the immune system

Gil¹,

Kenney²,

Mishra³

et al. 2015

Transactions of the Royal Society of Tropical Medicine and Hygiene

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“…Previous studies have shown that BCG has beneficial non-specific or heterologous effects, providing protection also against many non-tuberculosis causes of death: in randomized trials of early BCG to low-birth-weight children, BCG at birth versus delayed BCG, as is normal practice, decreased neonatal mortality by 38% (17–54%) [37–39]. With most infant deaths occurring during the neonatal period [40] and with less than half of children vaccinated during the first two weeks of life, most children do not benefit from BCG when they are most at risk.…”

Section: Discussionmentioning

confidence: 99%

Vaccination coverage and factors associated with adherence to the vaccination schedule in young children of a rural area in Burkina Faso

Kagoné

Yé

Nebié

et al. 2017

Global Health Action

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Background: Vaccination is an important tool for reducing infectious disease morbidity and mortality. In the past, less than 80% of children 12–23 months of age were fully immunized in Burkina Faso. Objectives: To describe coverage and assess factors associated with adherence to the vaccination schedule in rural area Burkina Faso. Methods: The study population was extracted from the Nouna Health and Demographic surveillance system cohort. Data from four rounds of interviews conducted between November 2012 and June 2014 were considered. This study included 4016 children aged 12–23 months. We assessed the effects of several background factors, including sex, factors reflecting access to health care (residence, place of birth), and maternal factors (age, education, marital status), on being fully immunized defined as having received Bacillus Calmette–Guérin (BCG), three doses of diphtheria–tetanus–pertussis and oral polio vaccine, and measles vaccine by 12 months of age. The associations were studied using binomial regression to derive prevalence ratios (PRs) in univariate and multivariate regression models. Results: The full vaccination coverage increased significantly over time (72% in 2012, 79% in 2013, and 81% in 2014, p = 0.003), and the coverage was significantly lower in urban than in rural areas (PR 0.84; 0.80–0.89). Vaccination coverage was neither influenced by sex nor influenced by place of birth or by maternal factors. Conclusion: The study documented a further improvement in full vaccination coverage in Burkina Faso in recent years and better vaccination coverage in rural than in urban areas. The organization of healthcare systems with systematic outreach activities in the rural areas may explain the difference between rural and urban areas.

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“…Fifty-nine articles were found, 15 were eligible for detailed analysis, and nine were included in the final analysis (Figures 2 and 3; Table 1) [10][11][12][13][14][15][16][17][18]. The nine studies with a low to moderate risk of bias consisted of two randomized trials, six cohort studies and one case-control study.…”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, most investigators did not record the strain of BCG that was used in the studies reported here. We know that BCG-Denmark was used in the two randomized trials in lowbirth-weight babies in Guinea-Bissau [9,10], but it cannot be assumed that other strains of BCG will have the same effect. BCG-Denmark and BCG-Japan both contain at least two different genomes, which may explain the considerable variation in clinical effects between batches from individual manufacturers.…”

Section: Journal Of Infectitious Diseases and Treatment Issn 2472-1093mentioning

confidence: 99%

“…Evidence that we eliminated major sources of bias is provided by the finding that the combined estimate for the seven observational studies of 0.57 (95% CI 0.46-0.71) was similar to the combined estimate for the two randomized trials of 0.52 (95% CI 0.33-0.82); the randomized trials had a low risk of bias. This large reduction in all-cause mortality, largely because of fewer deaths from pneumonia and sepsis [10][11], was not due to a specific effect of BCG on mycobacterial infection because tuberculosis is an uncommon cause of death in the first five years of life [6].…”

Section: Journal Of Infectitious Diseases and Treatment Issn 2472-1093mentioning

confidence: 99%

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Systematic Review of the Non-Specific Effects of Bacillus Calmette-Guérin Vaccine on Child Mortality

Cruz¹,

Almeida²,

Troster³

et al. 2017

J Infec Dis Treat

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Small Randomized Trial Among Low–birth-weight Children Receiving Bacillus Calmette-Guérin Vaccination at First Health Center Contact

Cited by 220 publications

References 4 publications

Vaccination and heterologous immunity: educating the immune system

Vaccination and heterologous immunity: educating the immune system

Vaccination coverage and factors associated with adherence to the vaccination schedule in young children of a rural area in Burkina Faso

Systematic Review of the Non-Specific Effects of Bacillus Calmette-Guérin Vaccine on Child Mortality

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