Comparative tuberculosis (TB) prevention effectiveness in children of Bacillus Calmette-Guérin (BCG) vaccines from different sources, Kazakhstan.
Comparative tuberculosis (TB) prevention effectiveness in children of Bacillus Calmette-Guérin (BCG) vaccines from different sources, Kazakhstan.
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来自哈萨克斯坦的不同来源的芽孢杆菌Callette-Guérin（BCG）疫苗儿童的比较结核病（TB）预防效果。
DOI：
10.1371/journal.pone.0032567
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Chorba T
中科院分区：
文献类型：
--
作者：
Favorov M;Ali M;Tursunbayeva A;Aitmagambetova I;Kilgore P;Ismailov S;Chorba T
除未常规接种卡介苗的1年期间外，自2002年以来，哈萨克斯坦婴儿卡介苗的年覆盖率超过95%。从2002年开始的连续4年，在可比较的7个月时间框架内（9月至3月）只使用来自不同来源（日本、塞尔维亚和俄罗斯）或没有来源的卡介苗制剂。我们的目的是评估卡介苗免疫的相对有效性。我们回顾性地比较了4个时间段出生队列的结果。三个队列只从三个制造商之一接种疫苗，一个队列未接种疫苗。对临床结核和培养证实结核的报告进行了3年的随访，对结核性脑膜炎的报告进行了21个月的随访。以结核发病率的相对风险为基础，计算每个接种疫苗的队列与未接种疫苗的队列的预防效果。虽然三种卡介苗的预防效果存在差异，但均具有保护作用。日本疫苗（目前在哈萨克斯坦使用）、塞尔维亚疫苗和俄罗斯疫苗对临床结核通报的有效率分别为69%、43%和22%，对培养确诊结核的有效率分别为92%、82%和51%。这三种疫苗对结核性脑膜炎的有效率均为70%。潜在的限制因素包括：1)使用的方法是回顾性的；2)多个危险因素可能在队列和受影响的预防有效性措施之间有所不同；3)大多数病例是临床诊断的，结核培养阳性病例数和结核脑膜炎病例数很少；4)报告的人群结核负担的微小变化可能影响队列的相对暴露风险。所有评估的三种卡介苗都对结核病有保护作用，预防效果因制造商而异。在制定国家免疫政策时，应考虑卡介苗制剂的预防效果。
Except during a 1-year period when BCG vaccine was not routinely administered, annual coverage of infants with Bacillus Calmette-Guérin (BCG) in Kazakhstan since 2002 has exceeded 95%. BCG preparations from different sources (Japan, Serbia, and Russia) or none were used exclusively in comparable 7-month time-frames, September through March, in 4 successive years beginning in 2002. Our objective was to assess relative effectiveness of BCG immunization. We compared outcomes of birth cohorts from the 4 time-frames retrospectively. Three cohorts received vaccine from one of three manufacturers exclusively, and one cohort was not vaccinated. Cohorts were followed for 3 years for notifications of clinical TB and of culture-confirmed TB, and for 21 months for TB meningitis notifications. Prevention effectiveness based on relative risk of TB incidence was calculated for each vaccinated cohort compared to the non-vaccinated cohort. Although there were differences in prevention effectiveness observed among the three BCG vaccines, all were protective. The Japanese vaccine (currently used in Kazakhstan), the Serbian vaccine, and the Russian vaccine respectively were 69%, 43%, and 22% effective with respect to clinical TB notifications, and 92%, 82%, and 51% effective with respect to culture confirmed TB. All three vaccines were >70% effective with respect to TB meningitis. Potential limitations included considerations that 1) the methodology used was retrospective, 2) multiple risk factors could have varied between cohorts and affected prevention effectiveness measures, 3) most cases were clinically diagnosed, and TB culture-positive case numbers and TB meningitis case numbers were sparse, and 4) small variations in reported population TB burden could have affected relative risk of exposure for cohorts. All three BCG vaccines evaluated were protective against TB, and prevention effectiveness varied by manufacturer. When setting national immunization policy, consideration should be given to prevention effectiveness of BCG preparations.
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DOI：
10.1164/rccm.201104-0714oc
发表时间：
2012-01-15
影响因子：
24.7
作者：
Ritz, Nicole;Dutta, Binita;Curtis, Nigel
通讯作者：
Curtis, Nigel
影响因子：
6.7
作者：
FINE, PEM
通讯作者：
FINE, PEM
DOI：
10.1016/0041-3879(86)90016-4
发表时间：
1986-12-01
期刊：
TUBERCLE
影响因子：
--
作者：
TIDJANI, O;AMEDOME, A;TENDAM, HG
通讯作者：
TENDAM, HG
影响因子：
3.6
作者：
ROMANUS, V
通讯作者：
ROMANUS, V
DOI：
10.1126/science.1184784
发表时间：
2010-05-14
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Russell DG;Barry CE 3rd;Flynn JL
通讯作者：
Flynn JL