Abstract
SummaryObjectiveTo investigate factors that determine the response to Bacille Calmette–Guérin (BCG) vaccination in urban environments with respect to socioeconomic status (SES), prenatal exposure to infections or newborn's nutritional status.MethodsThe study was conducted in an urban area, in Makassar, Indonesia. At baseline, 100 mother and newborns pair from high and low SES communities were included. Intestinal protozoa, soil transmitted helminths, total IgE, anti‐Hepatitis A Virus IgG and anti‐Toxoplasma IgG were measured to determine exposure to infections. Information on gestational age, birth weight/height and delivery status were collected. Weight‐for‐length z‐score, a proxy for newborns adiposity, was calculated. Leptin and adiponectin from cord sera were also measured. At 10 months of age, BCG scar size was measured from 59 infants. Statistical modelling was performed using multiple linear regression.ResultsBoth SES and birth nutritional status shape the response towards BCG vaccination at 10 months of age. Infants born to low SES families have smaller BCG scar size compared to infants born from high SES families and total IgE contributed to the reduced scar size. On the other hand, infants born with better nutritional status were found to have bigger BCG scar size but this association was abolished by leptin levels at birth.ConclusionThis study provides new insights into the importance of SES and leptin levels at birth on the development of BCG scar in 10 months old infants.
Highlights
Tuberculosis (TB) is known as one of the top 10 diseases causing high mortality worldwide
In Indonesia, Bacille Calmette–Guerin (BCG) vaccination is included in the Indonesian national immunisation programme and it is given to newborns at the age of 4–6 weeks
The results showed that the size of BCG scar remained larger in high socioeconomic status (SES) than low SES infants (Figure 3 Model 1)
Summary
Tuberculosis (TB) is known as one of the top 10 diseases causing high mortality worldwide. Bacille Calmette–Guerin (BCG) is a live-attenuated Mycobacterium bovis vaccine. It is the only available vaccine used to protect against TB disease, in particular meningitis and disseminated TB in children [2]. In Indonesia, BCG vaccination is included in the Indonesian national immunisation programme and it is given to newborns at the age of 4–6 weeks. Beside its protective effects against TB, BCG vaccination has shown to result in non-specific lower mortality and morbidity during childhood [3,4,5]. BCG scarification has been mentioned as a marker to a better survival and stronger immune response among BCG-vaccinated children living in countries with higher mortality rates [7, 8]
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