Assessment of the need for universal BCG vaccination of children in Taipei

Abstract

This retrospective study evaluated epidemiological trends in childhood tuberculosis (TB), and examined whether or not universal vaccination should be retained in Taipei City. Data of all recorded cases of TB among children from 2001 to 2005 were obtained from the TB Registry Database. The trend in TB incidence among children was analysed. Tuberculin skin tests were also performed to estimate the prevalence and annual risk of TB infection in second-grade school children. The average annual incidence of meningeal TB in children aged 0-4 years was 0.76 per 10 million general population for the previous 5 years. Among cases of pulmonary TB, smear-positive rates increased from 17.88 to 18.54 per 100,000 population during the study period. In second-grade children, the annual risk of TB infection was 1.01% in 2005, with an increasing trend over the study period. The findings indicate that one of the criteria established by the International Union against Tuberculosis and Lung Disease to discontinue universal BCG vaccination has been met in Taipei. Despite this favourable condition, considering that the sputum-smear-positive rates were as high as 20.11 per 100,000 population, universal BCG vaccination should be retained until the risk of exposure decreases.