A hospital-based survey of BCG coverage in Santo Domingo, the Dominican Republic.

A cross-sectional study was conducted in April-June 1992 at the outpatient clinic of the Robert Reid Children's Hospital in Santo Domingo to assess BCG vaccination coverage and factors affecting BCG vaccination of children. A consecutive sample of 2,000 patients under 18 years of age was included in the study. The person accompanying the patient to the hospital was interviewed, using a standardized questionnaire, and both of the patient's arms were examined for the presence of a BCG scar. Overall, 67.7% of the participants were found to have the scar and 68.3% were said to have received a BCG vaccination. However, only 80.8% of those with the scar were said to have been vaccinated. Multivariate logistic regression analysis found that residence in Santo Domingo, the subject's age, and the education of the subject's legal guardian were all significant predictors of the scar's presence, but that the strongest predictor was a history of immunization (OR = 6.29, 95% CI = 5.01, 7.89). Despite various limitations of this study, the results support other data indicating that the BCG vaccination program in the Dominican Republic needs to be strengthened. While the situation may be no worse than that found in a number of other Latin American countries, it appears that many Dominican children are not benefiting from the preventive effect of BCG vaccination and are therefore running an unnecessarily high risk of contracting tuberculosis.