title: Impact of BCG vaccination on tuberculin surveys to estimate the annual risk of tuberculosis infection in south India.
abstract: OBJECTIVE
  Annual risk of tuberculosis infection (ARTI) computed from prevalence of infection measures the extent of tuberculosis transmission in the community and it is used to monitor the tuberculosis control programme. This is usually derived from tuberculin surveys among children not vaccinated with BCG. This study explores whether the estimated ARTI among BCG vaccinated children is comparable to that of unvaccinated children.
  
  
  METHODS
  Three tuberculin surveys were undertaken among children aged >10 yr as part of assessing the impact of DOTS implemented in Tiruvallur district, south India. The prevalence of infection was estimated using the anti-mode method among vaccinated and unvaccinated children. The ARTI was computed separately and compared in all the three surveys.
  
  
  RESULTS
  The prevalence of infection among unvaccinated and vaccinated children in the first survey were 7.8 per cent (95% CI: 7.1-8.6) and 7.9 per cent (95% CI: 7.1-8.8) respectively (ARTI was estimated to be 1.6 per cent in both groups) and the difference was not statistically significant. The corresponding figures for children test read in the second and third surveys were 6.9 per cent (95% CI: 6.2-7.6) and 6.8 per cent (6.0-7.5) and; 6.0 per cent (5.2-6.7) and 6.0 per cent (5.5-6.5) respectively. The computed ARTI was respectively 1.4 and 1.2 per cent among unvaccinated children in the second and third surveys; and 1.4 and 1.2 per cent among vaccinated children in the second and third rounds.
  
  
  CONCLUSIONS
  There was no difference in the infection with Mycobacterium tuberculosis among vaccinated and unvaccinated children. BCG vaccinated children may thus be included for estimation of infection to assess the extent of transmission in the community as well as for monitoring purpose.
authors.affiliation: Tuberculosis Research Centre, (ICMR), Chennai, India.
authors.forename: P G
authors.initials: PG
authors.lastname: Gopi
authors.forename: R
authors.initials: R
authors.lastname: Subramani
authors.forename: T
authors.initials: T
authors.lastname: Nataraj
authors.forename: P R
authors.initials: PR
authors.lastname: Narayanan
mesh_terms: D000293:Adolescent; D001500:BCG Vaccine / Q000276:immunology*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D015995:Prevalence; D012306:Risk; D014374:Tuberculin Test; D014376:Tuberculosis / Q000453:epidemiology*; D014611:Vaccination
chemical_list: D001500:BCG Vaccine