THE INFLUENCE OF BCG VACCINATION ON THE STRUCTURE OF CLINICAL FORMS OF TUBERCULOSIS IN CHILDREN FROM THE FOCI OF INFECTION AND FROM UNSPECIFIED CONTACT FOR TUBERCULOSIS
1Department of Phthisiopulmonology, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2"Development Partners", Bishkek, Kyrgyz Republic
Objective: To study the frequency of detection of severe forms of tuberculosis in vaccinated and unvaccinated BCG vaccine in children from foci of infection.
Methods: There were 279 children with tuberculosis from the foci of infection: 178 (group I) of unvaccinated BCG and 101 (group II) vaccinated with BCG vaccine. In turn, these two groups were divided into two subgroups: non-vaccinated children from foci of infection (Ia) and unvaccinated children with unidentified contact (Ib) and vaccinated children from foci of infection (IIa) and with unidentified contact (IIb). An assessment was made of the forms of the disease, the frequency and nature of the complicated course of tuberculosis in vaccinated and non-vaccinated children.
Results: Severe forms such as tuberculous meningitis and disseminated tuberculosis were more likely to occur in the group of children not vaccinated with BCG vaccine at birth – 17.2% (p<0.05 compared with the group of vaccinated children). In vaccinated children, tuberculosis meningitis was established in 5.6%, and in non-vaccinated patients, this age group is almost twice as likely (9.3%). Disseminated pulmonary tuberculosis was detected in non-vaccinated children under the age of 6 years in 10.0% of cases and in one vaccinated child (2.1%). In children aged 7 to 17 years, these rates were 7.4% and 5.6% respectively. In vaccinated children, up to six years of age were established in 80.9% of all cases of tuberculosis, primary tuberculosis complex (29.8%) or tuberculosis of the intrathoracic lymph nodes (51.1%).
Conclusions: Thus, it can be argued that within six years after vaccination persists the body's ability to resist tuberculosis infection and in case of disease, severe forms of tuberculosis do not occur in vaccinated children. At the same time, as the BCG vaccine expires, the number of severe and common forms of tuberculosis increases. Therefore, the need for vaccination with BCG vaccine is evident, to prevent severe forms of the disease including such severe form of the disease, as tuberculous meningitis.
Keywords: BCG vaccination, clinical forms, efficacy.
- Global TB Report. WHO: Geneva; 2016. 342 p.
- Aksyonova VA, Sterlikov SA, Belilovskiy ЕМ. Zabolevaemost’ tuberkulyozom v Rossiyskoy Federatsii [Incidence of tuberculosis in the Russian Federation]. Tuberkulyos v Rossiyskoy Federatsii. 2014;1:288-90.
- Aggerbeck H, Giemza R, Joshi P. Randomised clinical trial investigating the specifity of a Novel skin test (c-TB) for diagnosis of M. tuberculosis infection. PloS One. 2013;8(5):e64215.
- Rangaka M, Wilkinson K, Glynn J. Predictive value of interferon gamma release assays for incident active tuberculosis: a systematic revier and meta-analysis. Lancet Infect Dis. 2012;12:45-55.
- Barmina NA, Baryshnikova LA, Shurygin АА, Reykhard VV. Skrining latentnoy tuberkulyoznoy infektsii s primeneniem allergena tuberkulyoznogo rekombinantnogo. Tuberkulyoz i bolezni lyogkikh. 2016;5:56-60.
- Aksyonova VA, Klevko SM, Kavtarashvili СМ. Ochag tuberkulyoznoy infektsii i ego znachenie v razvitii tuberkulyoza u detey [Tuberkulosnoy hotbed of infection and its importance in the development of children tuberculosis]. Tuberkulyoz i bolezni lyogkikh. 2015;1:19-24.
- Sirodjidinova UYu, Ismoilov SD, Pulatova LM, Bobokhodjaev OI, Pirov KI. Epidemiologicheskaya situatsiya po tuberkulyozu u detey iz ochagov infektsii [Epidemiological situation of tuberculosis in children from foci of infection]. Vestnik Avitsenny [Avicenna Bulletin]. 2012;1:109-12.
- Sirodjidinova UYu, Sharipov BP, Pirov KI. Vliyanie vaktsinatsii BTSZH na strukturu klinicheskikh form tuberkulyoza u detey [Influence of BCG vaccination on the structure of clinical forms of tuberculosis in children]. Tuberkulyoz i bolezni lyogkikh. 2014;8:39.
- Pirov K, Sirodjidinova U, Bobokhodjaev O, Zachariah R. Sluchai tuberkulyoza u detey v g. Dushanbe, Tadzhikistan [Cases of tuberculosis in children in Dushanbe, Tajikistan]. «Panorama» J Euro WHO. 2016;2(1):89-92.
- Pierry С, Duran V, Aceituno M. Tuberculosis disease in children; analysis of a BCG vaccinated population over the last ten years in Santiago (Chile). Europ Resp J. 2007;26:1224.
- Starshinova АА. Tuberkulyoz u detey iz semeynogo ochaga infektsii v sovremennykh usloviyakh (diagnostika, klinika i techenie) [Tuberculosis in children from a family foci of infection in modern conditions (diagnosis, clinic and flow)]. Byulleten’ Vostochno-Sibirskogo nauchnogo tsentra SO RAMN. 2011;2:104-5.
- Chebotaryova АА. Prichiny razvitiya i puti viyavleniya lokal’nykh form pervichnogo tuberkulyoza u detey v usloviyakh rayona s vysokoy zabolevaemost’yu vzroslogo naseleniya [Causes of development and ways of revealing local forms of primary tuberculosis in children in an area with a high incidence of adult population]. Tuberkulyoz i bolezni lyogkikh.2008;1:3-5.
- Chelnokova OG, Kibrik BS. Problemy tuberkulyoza u detey i podrostkov kontaktiruyushchikh s bol'nymi tuberkulyozom [Problems of tuberculosis in children and adolescents in contact with patients with tuberculosis]. Tuberkulyoz i bolezni lyogkikh. 2010;1:31-4.
- Yukhimenko NV, Ovsyankina ES, Kabulashvili MG. Znachenie medicosotsial'nogo statusa v razvitii tuberkulyoza u detey v sovremennykh epidemicheskikh usloviyakh [The importance of the medical and social status in the development of tuberculosis in children in modern epidemic condi-tions]. Tuberkulyoz i bolezni lyogkikh. 2012;8:30-3.
- Reed SG, Alderson MR, Dalemans W. Prospects for a better vaccine against tuberculosis. Tuberculosis. 2008;83(1):213-9.
- Thang PK. Assessment of tuberculosis infection and suffering in children of 0-5 years old in contact with ТВ patients. Intern J Tuberc Lung Dis. 2008;l:74.
Sirodjidinova Umrniso Yusupovna, Doctor of Medical Sciences, Full Professor, Professor of the Department of Phthisiopulmonology, Avicenna Tajik State Medical University
Bobokhojaev Oktam Ikramovich, Doctor of Medical Sciences, Professor of the Department of Phthisiopulmonology, Avicenna Tajik State Medical University
Pirov Kadriddin Ikromovich, Competitor of the Department of Phthisiopulmonology, Avicenna Tajik State Medical University
Kosimova Dilorom Mukhamadievna, Regional TB Coordinator, "Development Partners"
Address for correspondence:
Sirodjidinova Umrniso Yusupovna
Doctor of Medical Sciences, Full Professor, Professor of the Department of Phthisiopulmonology, Avicenna Tajik State Medical University
734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139
Tel.: (+992) 988 659457
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