SETTING: Revaccination of tuberculin-negative school-children is a regular practice in Hong Kong. OBJECTIVE: To assess the efficacy of BCG revaccination guided by tuberculin skin testing. METHOD: A cohort of 303,692 children vaccinated at birth was followed through the tuberculosis notification register for the development of active disease. The percentage of cohort who participated in the BCG revaccination program during primary school was estimated from the vaccination statistics of the Hong Kong Department of Health. The BCG revaccination history of identified cases was ascertained through vaccination cards and clinic records. RESULTS: A total of 85.2% of the cohort participated in the BCG revaccination programme; 79.7% of the participants were tuberculin-negative and revaccinated; 343 developed tuberculosis after the age of 11; 302 were among the participants in the programme while 41 were not. The tuberculosis incidence was 16.5 and 12.9 per 100,000 person-years for participants and non-participants, respectively (RR 1.28, 95%CI 0.92-1.77). Among the participants, tuberculosis incidence was 12.5 and 32.0/100,000 person-years, respectively, for the tuberculin-negative/BCG revaccinated group and the tuberculin-positive/non-revaccinated group (RR 0.39, 95%CI 0.31-0.49). CONCLUSION: This study failed to demonstrate any significant difference in the incidence rates of tuberculosis among participants and non-participants in a school BCG revaccination programme. The increased risk for tuberculosis in the tuberculin-positive group does not support the use of the tuberculin testing for detection of immunity conferred by neonatal BCG vaccination.
SETTING: Revaccination of tuberculin-negative school-children is a regular practice in Hong Kong. OBJECTIVE: To assess the efficacy of BCG revaccination guided by tuberculin skin testing. METHOD: A cohort of 303,692 children vaccinated at birth was followed through the tuberculosis notification register for the development of active disease. The percentage of cohort who participated in the BCG revaccination program during primary school was estimated from the vaccination statistics of the Hong Kong Department of Health. The BCG revaccination history of identified cases was ascertained through vaccination cards and clinic records. RESULTS: A total of 85.2% of the cohort participated in the BCG revaccination programme; 79.7% of the participants were tuberculin-negative and revaccinated; 343 developed tuberculosis after the age of 11; 302 were among the participants in the programme while 41 were not. The tuberculosis incidence was 16.5 and 12.9 per 100,000 person-years for participants and non-participants, respectively (RR 1.28, 95%CI 0.92-1.77). Among the participants, tuberculosis incidence was 12.5 and 32.0/100,000 person-years, respectively, for the tuberculin-negative/BCG revaccinated group and the tuberculin-positive/non-revaccinated group (RR 0.39, 95%CI 0.31-0.49). CONCLUSION: This study failed to demonstrate any significant difference in the incidence rates of tuberculosis among participants and non-participants in a school BCG revaccination programme. The increased risk for tuberculosis in the tuberculin-positive group does not support the use of the tuberculin testing for detection of immunity conferred by neonatal BCG vaccination.
Authors: Srabanti Rakshit; Asma Ahmed; Vasista Adiga; Bharath K Sundararaj; Pravat Nalini Sahoo; John Kenneth; George D'Souza; Wesley Bonam; Christina Johnson; Kees Lmc Franken; Tom Hm Ottenhoff; Greg Finak; Raphael Gottardo; Kenneth D Stuart; Stephen C De Rosa; M Juliana McElrath; Annapurna Vyakarnam Journal: JCI Insight Date: 2019-12-19
Authors: Mark Hatherill; Hendrik Geldenhuys; Bernadette Pienaar; Sara Suliman; Phalkun Chheng; Sara M Debanne; Daniel F Hoft; W Henry Boom; Willem A Hanekom; John L Johnson Journal: Vaccine Date: 2014-05-09 Impact factor: 3.641
Authors: H Martin Vordermeier; Shelley G Rhodes; Gillian Dean; Nilu Goonetilleke; Kris Huygen; Adrian V S Hill; R Glyn Hewinson; Sarah C Gilbert Journal: Immunology Date: 2004-07 Impact factor: 7.397
Authors: Darragh Duffy; Amina Dawoodji; Else Marie Agger; Peter Andersen; Jürgen Westermann; Eric B Bell Journal: PLoS One Date: 2009-12-14 Impact factor: 3.240