BCG vaccination scar associated with better childhood survival in Guinea-Bissau
(2005) In International Journal of Epidemiology 34(3). p.540-547- Abstract
- BACKGROUND: Recent studies have suggested that Bacille Calmette-Guerin (BCG) vaccination may have a non-specific beneficial effect on infant survival and that a BCG scar may be associated with lower child mortality. No study has previously examined the influence of BCG vaccination on cause of death. METHODS: Two cohorts (A and B) were used to describe the mortality pattern for children with and without BCG scar and to determine specific causes of death. In cohort A (n = 1813), BCG scar was assessed at 6 months of age and as previously described children with a BCG scar had lower mortality over the next 12 months than children with no BCG scar. In cohort B, 1617 children aged 3 months to 5 years of age had their BCG scar status assessed in... (More)
- BACKGROUND: Recent studies have suggested that Bacille Calmette-Guerin (BCG) vaccination may have a non-specific beneficial effect on infant survival and that a BCG scar may be associated with lower child mortality. No study has previously examined the influence of BCG vaccination on cause of death. METHODS: Two cohorts (A and B) were used to describe the mortality pattern for children with and without BCG scar and to determine specific causes of death. In cohort A (n = 1813), BCG scar was assessed at 6 months of age and as previously described children with a BCG scar had lower mortality over the next 12 months than children with no BCG scar. In cohort B, 1617 children aged 3 months to 5 years of age had their BCG scar status assessed in a household-based survey and mortality was assessed during a 12-month period. Causes of death were determined by verbal autopsy (VA) and related to BCG scar status in a cause-specific hazard function. RESULTS: Controlling for background factors associated with mortality, there was lower mortality for children with a BCG scar than without in cohort B, the mortality ratio (MR) being 0.45 (95% CI 0.21-0.96). Exclusion of children exposed to TB did not have any impact on the result. In a combined analysis of cohorts A and B, the MR was 0.43 (95% CI 0.28-0.65) controlling for background factors. There were no large differences in distribution of the five major causes of death (malaria, pneumonia, acute diarrhoea, chronic diarrhoea, and meningitis/encephalitis) according to BCG scar status in the two cohorts. Having a BCG scar significantly reduced the risk of death from malaria [MR 0.32 (95% CI 0.13-0.76)]. CONCLUSIONS: A BCG scar is a marker of better survival among children in countries with high child mortality. BCG vaccination may affect the response to several major infections including malaria. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1132564
- author
- Roth, Adam LU ; Gustafson, Per LU ; Nhaga, Alexandro ; Djana, Queba ; Poulsen, Anja ; Garly, May-Lill ; Jensen, Henrik ; Sodemann, Morten ; Rodriques, Amabelia and Aaby, Peter
- organization
- publishing date
- 2005
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- non-specific effects of vaccines, cause of death, verbal autopsy, infant mortality, BCG
- in
- International Journal of Epidemiology
- volume
- 34
- issue
- 3
- pages
- 540 - 547
- publisher
- Oxford University Press
- external identifiers
-
- pmid:15659474
- scopus:20744438949
- pmid:15659474
- ISSN
- 1464-3685
- DOI
- 10.1093/ije/dyh392
- language
- English
- LU publication?
- yes
- id
- 224e7a22-8ca1-43a3-a8d4-1cfec02f4b47 (old id 1132564)
- date added to LUP
- 2016-04-01 11:54:42
- date last changed
- 2022-05-14 06:48:33
@article{224e7a22-8ca1-43a3-a8d4-1cfec02f4b47, abstract = {{BACKGROUND: Recent studies have suggested that Bacille Calmette-Guerin (BCG) vaccination may have a non-specific beneficial effect on infant survival and that a BCG scar may be associated with lower child mortality. No study has previously examined the influence of BCG vaccination on cause of death. METHODS: Two cohorts (A and B) were used to describe the mortality pattern for children with and without BCG scar and to determine specific causes of death. In cohort A (n = 1813), BCG scar was assessed at 6 months of age and as previously described children with a BCG scar had lower mortality over the next 12 months than children with no BCG scar. In cohort B, 1617 children aged 3 months to 5 years of age had their BCG scar status assessed in a household-based survey and mortality was assessed during a 12-month period. Causes of death were determined by verbal autopsy (VA) and related to BCG scar status in a cause-specific hazard function. RESULTS: Controlling for background factors associated with mortality, there was lower mortality for children with a BCG scar than without in cohort B, the mortality ratio (MR) being 0.45 (95% CI 0.21-0.96). Exclusion of children exposed to TB did not have any impact on the result. In a combined analysis of cohorts A and B, the MR was 0.43 (95% CI 0.28-0.65) controlling for background factors. There were no large differences in distribution of the five major causes of death (malaria, pneumonia, acute diarrhoea, chronic diarrhoea, and meningitis/encephalitis) according to BCG scar status in the two cohorts. Having a BCG scar significantly reduced the risk of death from malaria [MR 0.32 (95% CI 0.13-0.76)]. CONCLUSIONS: A BCG scar is a marker of better survival among children in countries with high child mortality. BCG vaccination may affect the response to several major infections including malaria.}}, author = {{Roth, Adam and Gustafson, Per and Nhaga, Alexandro and Djana, Queba and Poulsen, Anja and Garly, May-Lill and Jensen, Henrik and Sodemann, Morten and Rodriques, Amabelia and Aaby, Peter}}, issn = {{1464-3685}}, keywords = {{non-specific effects of vaccines; cause of death; verbal autopsy; infant mortality; BCG}}, language = {{eng}}, number = {{3}}, pages = {{540--547}}, publisher = {{Oxford University Press}}, series = {{International Journal of Epidemiology}}, title = {{BCG vaccination scar associated with better childhood survival in Guinea-Bissau}}, url = {{http://dx.doi.org/10.1093/ije/dyh392}}, doi = {{10.1093/ije/dyh392}}, volume = {{34}}, year = {{2005}}, }