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Revaccination with Bacillus Calmette-Guerin (BCG) vaccine does not reduce morbidity from malaria in African children

Rodrigues, Amabelia; Schellenberg, Joanna Armstrong; Roth, Adam LU ; Benn, Christine Stabell; Aaby, Peter and Greenwood, Brian (2007) In Tropical Medicine & International Health 12(2). p.224-229
Abstract (Swedish)
Abstract in French

Donnees de base 



Des études menées en Arique de l'ouest et ailleurs ont suggeree que le vaccin Bacille Calmette-Guerin (BCG) administréà la naissance était bénéfique pour la survie de l'enfant. Cet effet bénéfique proviendrait en partie de l'effet sur la malaria, une hypothèse supportée par des études sur animal. Nous avons investigué si la revaccination avec le BCG à 19 mois reduisait la morbidité due à la malaria. Méthodes 



Dans la capital de Guinée Bissau, entre Janvier et Novembre 2003, des enfants qui avaient déjà recu le BCG et qui qui ne présentaient pas une forte réponse de la raction à la tuberculine ont été randomisés individuellement pour soit recevoir une... (More)
Abstract in French

Donnees de base 



Des études menées en Arique de l'ouest et ailleurs ont suggeree que le vaccin Bacille Calmette-Guerin (BCG) administréà la naissance était bénéfique pour la survie de l'enfant. Cet effet bénéfique proviendrait en partie de l'effet sur la malaria, une hypothèse supportée par des études sur animal. Nous avons investigué si la revaccination avec le BCG à 19 mois reduisait la morbidité due à la malaria. Méthodes 



Dans la capital de Guinée Bissau, entre Janvier et Novembre 2003, des enfants qui avaient déjà recu le BCG et qui qui ne présentaient pas une forte réponse de la raction à la tuberculine ont été randomisés individuellement pour soit recevoir une revacination BCG à 19 mois d'âge ou soit comme contrôle. Les épisodes de malaria ont été enregistrés durant la saison de transmission de 2003 à travers une détection passive des cas dans les centres de santé de l'endroit étudié et dans l'hôpital national. Une étude transversale a été menée au début et à la fin la saison des pluies. Résultats 



Les taux d'incidence des premiers épisodes de malaria associés avec tout niveau de parasitémie étaient de 0,16 épisodes par enfant/année parmi 713 enfants revaccinés et 0,12 parmi 720 enfants contrôles (IRR = 1,37; IC95%: 0,82-2,25). Les résultats étaient similaires lorsque le diagnostic de la malaria etait basé sur la présence de parasitémie >5000 parasites/μl (IRR = 1,30; IC95%: 0,61-2,77). L'incidence de toute cause d'hospitalisations était plus elevée chez les enfants revaccinés par le BCG que chez les contrôles (IRR = 2,13; IC95%: 1,10-4,13). Il n'y avait pas de différence significative dans la prévalence de parasitémie entre les deux groupes d'enfants dans les études tranversales. Conclusions 



Aucune evidence de la réduction de la morbidité de la malaria n'a été trouvée avec la revaccination par le BCG. (Less)
Abstract
BACKGROUND: Studies in West Africa and elsewhere have suggested that Bacillus Calmette-Guerin (BCG) vaccine given at birth is beneficial for child survival. It is possible that this effect is mediated partly through an effect on malaria, a hypothesis supported by animal studies. We investigated whether revaccination with BCG at 19 months of age reduced morbidity from malaria. METHOD: In the capital of Guinea-Bissau, between January and November 2003, children who had previously received BCG vaccination and who did not have a strong reaction to tuberculin were individually randomised to either receive revaccination with BCG at the age of 19 months or to be a control. Episodes of malaria were recorded during the 2003 malaria transmission... (More)
BACKGROUND: Studies in West Africa and elsewhere have suggested that Bacillus Calmette-Guerin (BCG) vaccine given at birth is beneficial for child survival. It is possible that this effect is mediated partly through an effect on malaria, a hypothesis supported by animal studies. We investigated whether revaccination with BCG at 19 months of age reduced morbidity from malaria. METHOD: In the capital of Guinea-Bissau, between January and November 2003, children who had previously received BCG vaccination and who did not have a strong reaction to tuberculin were individually randomised to either receive revaccination with BCG at the age of 19 months or to be a control. Episodes of malaria were recorded during the 2003 malaria transmission season through passive case detection at health centres in the study area and at the national hospital. Cross-sectional surveys were carried out at the beginning and at the end of the rainy season. RESULTS: Incidence rates of first episodes of malaria associated with any level of parasitaemia were 0.16 episodes per child-year among 713 revaccinated children and 0.12 among 720 control children [incidence rate ratio (IRR) = 1.37; 95% confidence intervals (CI): 0.84-2.25]. Results were similar when the diagnosis of malaria was based on the presence of parasitaemia >5000 parasites/microl (IRR = 1.30; 95% CI: 0.61-2.77). The incidence of all-cause hospitalisation was higher among BCG-revaccinated children than among controls (IRR = 2.13; 95% CI: 1.10-4.13). There were no significant differences in the prevalence of parasitaemia between the two groups of children at cross-sectional surveys. CONCLUSION: We found no evidence that BCG revaccination reduces morbidity from malaria. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
malaria morbidity, BCG revaccination, children, revaccination par le BCG, morbidité due à la malaria, enfants, revacunación BCG, morbilidad por malaria, niños
in
Tropical Medicine & International Health
volume
12
issue
2
pages
224 - 229
publisher
Wiley-Blackwell
external identifiers
  • pmid:17300629
  • scopus:33846941602
ISSN
1365-3156
DOI
10.1111/j.1365-3156.2006.01766.x
language
English
LU publication?
yes
id
db34cdc6-0f71-490b-8fc8-98e820614b21 (old id 1140348)
date added to LUP
2008-08-25 10:09:08
date last changed
2017-01-01 06:43:07
@article{db34cdc6-0f71-490b-8fc8-98e820614b21,
  abstract     = {BACKGROUND: Studies in West Africa and elsewhere have suggested that Bacillus Calmette-Guerin (BCG) vaccine given at birth is beneficial for child survival. It is possible that this effect is mediated partly through an effect on malaria, a hypothesis supported by animal studies. We investigated whether revaccination with BCG at 19 months of age reduced morbidity from malaria. METHOD: In the capital of Guinea-Bissau, between January and November 2003, children who had previously received BCG vaccination and who did not have a strong reaction to tuberculin were individually randomised to either receive revaccination with BCG at the age of 19 months or to be a control. Episodes of malaria were recorded during the 2003 malaria transmission season through passive case detection at health centres in the study area and at the national hospital. Cross-sectional surveys were carried out at the beginning and at the end of the rainy season. RESULTS: Incidence rates of first episodes of malaria associated with any level of parasitaemia were 0.16 episodes per child-year among 713 revaccinated children and 0.12 among 720 control children [incidence rate ratio (IRR) = 1.37; 95% confidence intervals (CI): 0.84-2.25]. Results were similar when the diagnosis of malaria was based on the presence of parasitaemia >5000 parasites/microl (IRR = 1.30; 95% CI: 0.61-2.77). The incidence of all-cause hospitalisation was higher among BCG-revaccinated children than among controls (IRR = 2.13; 95% CI: 1.10-4.13). There were no significant differences in the prevalence of parasitaemia between the two groups of children at cross-sectional surveys. CONCLUSION: We found no evidence that BCG revaccination reduces morbidity from malaria.},
  author       = {Rodrigues, Amabelia and Schellenberg, Joanna Armstrong and Roth, Adam and Benn, Christine Stabell and Aaby, Peter and Greenwood, Brian},
  issn         = {1365-3156},
  keyword      = {malaria morbidity,BCG revaccination,children,revaccination par le BCG,morbidité due à la malaria,enfants,revacunación BCG,morbilidad por malaria,niños},
  language     = {eng},
  number       = {2},
  pages        = {224--229},
  publisher    = {Wiley-Blackwell},
  series       = {Tropical Medicine & International Health},
  title        = {Revaccination with Bacillus Calmette-Guerin (BCG) vaccine does not reduce morbidity from malaria in African children},
  url          = {http://dx.doi.org/10.1111/j.1365-3156.2006.01766.x},
  volume       = {12},
  year         = {2007},
}