Acute Lower Respiratory Infection Among Bacille Calmette-Guérin (BCG)–Vaccinated Children
- 1 January 2014
- journal article
- Published by American Academy of Pediatrics (AAP)
- Vol. 133 (1), e73-e81
- https://doi.org/10.1542/peds.2013-2218
Abstract
OBJECTIVE: To determine whether Bacille Calmette-Guerin (BCG) vaccination is linked to the risk of acute lower respiratory infection (ALRI) among children <5 years of age.METHODS: Data from Macro International Demographic and Health Surveys and United Nations Children’s Fund Multiple Indicator Cluster Surveys were used to identify a primary cohort of 58 021 children in 19 countries (2005–2010) and a secondary cohort of 93 301 children in 18 countries (2000–2007). Information was collected by trained interviewers during home visits using standardized questionnaires, review of vaccination health cards, and measurement of health indicators.RESULTS: BCG vaccination was associated with a 17% to 37% risk reduction for suspected ALRI in both cohorts. The only vaccine or vitamin supplement to modify the effect of BCG was diphtheria-tetanus-pertussis (DTP; P < .001). The order in which the vaccines were first received was central to this phenomena (BCG before DTP, adjusted/propensity score–weighted relative risk [apRR]: 0.79, 95% confidence interval [CI]: 0.70–0.89; BCG with DTP, apRR: 0.82, 95% CI: 0.71–0.94; and BCG after DTP, apRR: 1.00, 95% CI: 0.87–1.13) but not number of DTP doses received. Other modifiers included vaccine strain used in immunization programs, chlorinating drinking water, using wood-burning fuel cook stoves, and owning livestock.CONCLUSIONS: Children vaccinated with BCG had a significantly lower risk of suspected ALRI. Clarification is needed as to whether this is due to reductions in the underlying risk of tuberculosis or ALRI per se.Keywords
This publication has 39 references indexed in Scilit:
- A review of diseases associated with household air pollution due to the use of biomass fuelsJournal of Hazardous Materials, 2011
- Multiple imputation by chained equations: what is it and how does it work?International Journal of Methods in Psychiatric Research, 2011
- The challenge of assessing infant vaccine responses in resource-poor settingsExpert Review of Vaccines, 2010
- Randomized Trials to Study the Nonspecific Effects of Vaccines in Children in Low-Income CountriesThe Pediatric Infectious Disease Journal, 2010
- Multiple Imputation With Large Data Sets: A Case Study of the Children's Mental Health InitiativeAmerican Journal of Epidemiology, 2009
- Environmental Strains of Mycobacterium avium Interfere with Immune Responses Associated with Mycobacterium bovis BCG VaccinationInfection and Immunity, 2007
- Genome plasticity of BCG and impact on vaccine efficacyProceedings of the National Academy of Sciences, 2007
- The influence of previous exposure to environmental mycobacteria on the interferon-gamma response to bacille Calmette–Guérin vaccination in southern England and northern MalawiClinical and Experimental Immunology, 2006
- Impact of vaccinations and infectious diseases on the risk of melanoma—evaluation of an EORTC case–control studyEuropean Journal Of Cancer, 2003
- EVALUATION OF SIMPLE CLINICAL SIGNS FOR THE DIAGNOSIS OF ACUTE LOWER RESPIRATORY TRACT INFECTIONThe Lancet, 1988