Comparison of the prevalence of tuberculosis infection in BCG vaccinated versus nonvaccinated school age children.
OBJECTIVE
To compare the prevalence of tuberculosis infection in BCG vaccinated versus non-vaccinated school age children in a tuberculosis endemic region.


METHODS
Cross-sectional, case control, school based survey.


METHODS
Government lower primary school in Palakkad District, Kerala.


METHODS
Tuberculosis infection was determined by tuberculin testing in 418 school children aged 5 to 9 years, utilizing a differential outcome variable definition for BCG vaccinated and unvaccinated children, in a tuberculosis endemic area with moderate vaccination coverage. Nutritional status was calculated using weight for age and weight for height criteria.


RESULTS
Tuberculin positivity rate in unvaccinated children (24%) was significantly higher than in the vaccinated (9.7%) (P<0.001, RR: 2.9). Overall prevalence rate of tuberculosis infection was 15.5%. Boys had significantly higher vaccination rates than girls (P < 0.001). No association was found between tuberculin reaction size and age or nutritional status.


CONCLUSIONS
BCG vaccination is associated with significant protection against the acquisition of Mycobacterium tuberculosis infection in childhood. This finding highlights the importance of universal implementation of BCG vaccination in children in tuberculosis endemic regions.
Pulickal
Anoop Sebastian
AS
Department of Pediatrics, John Radcliffe Hospital, Oxford OX3 9DU, UK. anoop.sebastian@pediatrics.ox.ac.uk
Fernandez
Gerald Vincent Joseph
GV
D001500:BCG Vaccine; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks; D005260:Female; D006306:Health Surveys; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D009752:Nutritional Status; D015995:Prevalence; D012307:Risk Factors; D012574:Schools; D014374:Tuberculin Test; D014376:Tuberculosis / Q000453:epidemiology* / Q000517:prevention & control*; D014611:Vaccination / Q000706:statistics & numerical data*
D001500:BCG Vaccine