BCG Scar Research Articles

Correlation Of BCG Vaccination And COVID-19 Disease Through Measurement Of Immunological Markers IFN-Γ And Anti-BCG Igg In Different Age Groups Running Title: Correlation Between BCG Vaccination And COVID-19 Disease

Introduction Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China in December 2019 and then became a pandemic. BCG vaccination has conferred non-specific (targeted-off) protective effects against unrelated pathogens including respiratory viral infections that have been hypothesized to it could reduce the severity of COVID-19 disease. Objective: Assess whether BCG vaccination has a role in the prevention of COVID-19. Methods: A cross-sectional study including 111 healthy people was carried out from October 2021 to December 2022. Specific anti-BGC-IgG and IFN-γ levels were estimated in blood samples after stimulation with BCG vaccine for 2 days. All participants were examined for BCG scar status and COVID-19 confirmation. Results: There was no significant difference in anti-BCG IgG levels or IFN-γ levels (p>0.05) in relation to COVID-19 infection. There was no statistically significant association between BCG scar diameter and COVID-19 infection (p>0.05). Furthermore, there was no statistically significant association between the BCG scar diameter and COVID-19 severity (p>0.05). There was no significant difference in anti-BCG IgG levels (p>0.05) in relation to COVID-19 severity. Likewise, there was no significant difference in between IFN γ levels and COVID-19 severity (p>0.05). Conclusion: There was no correlation between BCG vaccination and infection or severity of COVID-19.

Age and gender in drug resistance tuberculosis: A cross-sectional case study at a national tuberculosis reference hospital in Nigeria

ObjectivesDrug resistance in tuberculosis (TB) is a very important public health threat that should not be ignored. Understanding the gender, age, and characteristics of individuals affected by TB (without HIV, diabetes, or hepatitis B complications), particularly in terms of drug resistance or susceptibility, is crucial for effective prevention and management strategies, as most studies focus on TB/HIV co-infection. MethodsA cross-sectional case study of age and gender was carried out in 140 individuals grouped into drug-resistant tuberculosis (DR-TB), drug-susceptible tuberculosis (DS-TB), and apparently healthy controls (AHCs). Data collection was through medical records and a structured questionnaire. Statistical analyses compared age, gender, and selected risk factors across the groups. ResultsThe mean age of the DR-TB group was 32 years (SD ≈ 2). A total of 80.0% were ≤40 years of age and four times more likely to have DR-TB; 55% were male, with 1.22 times more likelihood of DR-TB in males. The mean age of the DS-TB group was 34 years (SD ≈ 12); 66.7% were ≤40 years old. The odds ratio of DS-TB in males was 2.16. Only 10% of DR-TB enrolees had BCG scars compared with 65% AHCs. A high percentage of the DR-TB group reported handling raw meat (75%) and drinking unpasteurised milk (70%) compared with the DS-TB group. ConclusionsThe observed gender disparities and age-related factors, particularly among the DR-TB group, highlight the importance of considering age and gender factors in DR-TB prevention, diagnosis, and treatment. Our findings also highlight the need to bridge gaps in awareness as well as for the prevention of zoonotic TB and issues around effective BCG vaccination and coverage.

Risk factors of tuberculosis in children with adult household tuberculosis contact

Background Since children are more likely than adults to become infected with Mycobacterium tuberculosis or suffer from tuberculosis (TB), it is important to identify the risk factors of TB in children with adult household TB contacts. Objective To identify the risk factors of TB in children with adult household TB contacts. Methods This cross-sectional study was conducted at the Pediatric Respirology Inpatient Ward and Outpatient Clinic at Dr. Soetomo Hospital, Surabaya, Indonesia, using medical records of hospitalized patients from 2010 to 2018. Patients were children below 18 years of age who had a history of adult TB household contact(s). We analyzed age at TB diagnosis, nutritional status, BCG vaccination status, and HIV status as possible risk factors of TB. Results A total of 367 children with adult household TB contacts were included in our study. Age of <5 years (OR 8.38; 95%CI 3.78 to 18.21; P<0.001), severe malnutrition (OR 8.88; 95%CI 1.19 to 66.27, P<0.05), absence of BCG scar (OR 2.96; 95%CI 1.32 to 6.62, P<0.05), and positive HIV status (OR 6.72; 95%CI 1.72-38.49, P<0.05) were risk factors for contracting active TB. Conclusion Age of <5 years, severe malnutrition, absence of BCG scar, and positive HIV status are significant risk factors for active TB in children with adult household TB contacts.

Socio-cultural and Environmental Risk Factors for Leprosy in Jaffna District, Sri Lanka

This study was conducted to determine the socio-cultural and environmental risk factors of leprosy in Jaffna. A case-control study was conducted in dermatology clinic, teaching hospital, Jaffna from July 2015 to July 2016. All 97 cases and 291 controls by systematic sampling were recruited using interviewer-administered questionnaire.The mean age of cases was 41 (SD=21) and control was 48 (SD=20). Of 97 cases, 54.6 %( n=53) males; 99 %( n=96) Tamils; 79.4 %( n=77) Hindus; 60 %( n=59) above secondary education. Of 291 controls, 42.3 %( n=123) were males; 99.3 %( n=289) Tamils; 85.6 % (n=249) Hindus; 78.4 % ( n=225) above secondary education.Socio demographic factors (12 variables), house and environmental factors (11 variables), and behavioral factors (18 variables) were included in bivariate analysis and many were found to be significantly (p<0.05) associated with leprosy. Marital status, displacement, monthly income, presence of BCG scar, firewood as cooking fuel, and hunting reptiles were not found to be associated with leprosy. Multiple logistic regression analysis showed significant association between leprosy and - crowded household [OR4.5, (1.5-13.6)], non-availability of drinking water within 30 minutes walking [OR15.1, (2.3-98.3)], environment with shrub [OR2.9, (1.4-6.1)], exposure to shrub [OR2.7, (1.2-5.9)], exposure to leprosy patient [OR10.6, (4.1-27.5)], exposure to fishing [OR4.5, (1.5- 13.6)], visits to leprosy affected area [OR10.8, (4.7-24.5)] and unavailability of safe water source [OR3.3, (1.2- 9.1)]. In addition to the well-known risk factors environment-related risk factors, especially exposure to jungle/shrubs could play a role in the transmission of leprosy.

Surveillance of close contacts of patients with infectious tuberculosis: a prospective cohort study

BackgroundA long-term follow-up of close contacts to monitor their infection status is essential to formulate a promising screening strategy. The study aimed to assess the dynamics of tuberculosis (TB) infection using Interferon-γ release assay (IGRA) and determine risk factors associated with TB infection.MethodsDefinite TB patients were interviewed and their household contacts were screened for TB infection by IGRA during 12-month longitudinal investigation.ResultsWe included in our analyses 184 household contacts of 92 index TB patients. 87 individuals (47.3%) in contact group progressed to TB infection, of whom 86 developed into IGRA positive within 24 weeks. Close contacts with a higher age and comorbidities are easier to exhibit TB infection. Analysis showed that risk factors for becoming IGRA-positive individuals included residence, older age, comorbidities, BCG scar and high bacterial load. Contacts with BCG scar had a lower IGRA-positive rate.ConclusionIGRA conversion generally occurs within 24 weeks after exposure. The TB transmission happens since subclinical TB stage and the presence of BCG scar is an independent protective factor reducing risk of TB infection among close contacts. Repeated IGRA tests are sensible to conducted among close contacts at 24 weeks after exposure to identify the IGRA-positive individuals.

Case Report: Milliary TB in Adolescence Diagnosed in Tapin, South Kalimantan, A Call for TB Awereness

This case report presents the clinical scenario of a 15-year-old adolescent admitted to the emergency room with complaints of shortness of breath and a persistent productive cough for the past 3 weeks, despite over-the-counter medication. The cough did not improve with over-the-counter medication. He also sometimes noticed blood stains in his phlegm. During the physical examination, a BCG scar was found on the right upper arm. The results showed that positive HIV status and the absence of BCG scars were significantly associated with miliary TB and extrapulmonary TB. However, in this case, both factors were not detected. The treatment regimen for miliary TB requires therapy for a minimum of 12 months, but teenagers experience difficulties in undergoing therapy due to the consumption of illegal drugs every day for a long period of time. Apart from that, social isolation and disrupted daily activities are also challenges for teenagers. The death rate from miliary TB in children reaches 15-20%, highlighting the importance of awareness of this disease. Therefore, handling and treating TB in adolescents requires special attention and further efforts to reduce the risk of treatment failure. Awareness of TB, especially in adolescents with chronic respiratory symptoms, must be increased to overcome this challenge in the future.

Occurence and risk factors of tuberculosis infection in orphanage children in Bali

Background Tuberculosis (TB) is an infectious disease that is still a common threat worldwide, especially in pediatric populations. TB transmission occurs particularly when the transmitter has no obvious manifestation of the disease. There is a higher incidence of TB infection in children than in the general population, especially in high risk populations such as children in orphanages. However, the incidence of TB infection in orphaned children in Indonesia, including Bali, is unknown. Objective To describe the incidence and risk factors for TB infection in children in orphanages in Bali. Methods This case-control study was conducted in 12 orphanages in Bali. Subjects were divided into a case group comprised of children with TB infection, and a control group comprised of those without TB infection. TB infection was diagnosed by positive tuberculin test without clinically confirmed TB. Results A total of 175 children were recruited as subjects. There were 49 (28.0%) children with TB infection. Bivariate analysis revealed significant associations between density, humidity, ventilation/room area ratio, and area of ??origin with TB infection. Multivariate analysis showed that ventilation/room area ratio and room humidity of ?73% were independently positive correlated with TB infection. Natural lighting and BCG scar were not significantly different between groups. Conclusion The occurence of TB infection in children residing in orphanages in Bali is high (28%). The risk factors identified independently are lower ventilation and higher room humidity.

Prevalence and risk factors of tuberculosis infection in orphanage children in Bali, Indonesia

Background: Tuberculosis (TB) is an infectious disease that causes high morbidity and mortality worldwide. Indonesia ranks third in the most TB cases in 2020 globally. Orphanages are densely populated places with a high risk of transmission, but routine TB screening programs have yet to be carried out. This study aims to find the prevalence of tuberculosis infection and its risk factors in orphanage children. Methods: This study used a cross-sectional approach. The data collected included age, gender, nutritional status, stunting, BCG scars, and abnormalities in physical examination. History, physical examination, and tuberculin test are the screening programs performed. All children with a positive tuberculin test as an induration of 10 mm 72 hours after the tuberculin test underwent a chest X-ray. Results: We conducted tuberculosis screening for 262 children in 15 orphanages in Denpasar and Badung from July to October 2022. There is no known history of contact with active TB sufferers. No active tuberculosis infection was detected. Latent tuberculosis infection (LTBI) occurred in 57 children (21.7%), 48 (84.2%) aged 10-17 years, 28 (49.1%) were male, 54 (94.7%) had normal nutritional status, 13 (22.8%) were stunted, and no BCG scars in 28 (49.1%). No BCG scar was a risk factor for LTBI with OR 2.29 (95% CI 1.06 - 4.97; p 0.03). Conclusion: One-fifth of orphanage children suffer from LTBI, and no BCG scar was a risk factor for LTBI. TB screening should be done routinely and actively in the orphanage.

CLINICAL PROFILE AND OUTCOME OF PEDIATRIC TUBERCULOSIS IN A TERTIARY CARE SETTING IN CENTRAL INDIA

Objective: To study the clinical profile and outcome of tuberculosis (TB) in children under 14 years of age. Methods: It is a hospital-based cross-sectional study done in a tertiary referral center in Central India from July 2017 to June 2019. After ethical approval, 80 children (under 14 years of age) diagnosed with presumptive TB were enrolled. Those already on TB treatment or prophylaxis for more than 7 days were excluded from the study. Relevant patient details were noted on a predesigned pro forma. Routine first-line investigations for TB were done in all cases. Histopathological and specific radiology tests were done as per the site involved. Microbiological confirmation was done using microscopy, and molecular diagnosis was done by a cartridge-based nucleic acid amplification test (CBNAAT). Results: Overall mortality was 13.8%, and 82% of them were children below 5 years of age. As per WHO criteria, 52.5% and 20% of children below 5 years of age were severely and moderately undernourished, respectively. History of contact was present in 66%; BCG scar in 91.3%; and tuberculin sensitivity test positivity in 56% of cases. Fever, cough, and weight loss were the most common presenting complaints. The majority had extrapulmonary involvement (75%), with neurotuberculosis being the most common and with the highest mortality (70%). Microbiological confirmation was possible in only 8.8% of cases. Conclusion: It is still challenging to diagnose pediatric TB. Though newer diagnostics are now available, clinical suspicion is a valuable tool. The diagnosis of pediatric TB should thus be based on a combination of epidemiological variables, clinical suspicion, and supported by various laboratory investigations.

Percentage and Absolute CD4+ Count and Factors Influencing Their Levels in Tuberculosis Patients in a Tetiary Hospital, Kaduna, Nigeria

Background: The role of CD4+ T cells in immunity against tuberculosis have been widely acknowledged. This study determined CD4+ absolute, CD4 percentage and haemoglobin (HB) levels in tuberculosis (TB) patients undergoing TB treatment and compared these levels with presence of some factors which could modify the quantities of CD4+, CD4% and HB in TB patients. Methods: A cross-sectional study of eighty-five persons attending TB DOTS clinic in tertiary hospital between 2020 to 2021. Multicolour fluorescence imaging and absorbance spectrometry microscopy was used to enumerate CD4+ absolute count, CD4+ percentage and HB concentration in whole blood. Questionnaire and interviews were used to determine history, demographic data, BCG vaccination, BCG scar, vitamin A supplementation, awareness of zoonotic diseases and zoonotic TB, maternal BCG vaccination status, maternal BCG scar and undernutrition for each respondent. Results: CD4% significantly differed between forty-seven males (mean age: 33.5) and thirty-eight females (mean age: 32.2) (p <0.05). T-test indicated no significant difference in CD4+ count, CD4% and HB compared with BCG vaccination status, presence of BCG scar, knowledge of zoonotic diseases, knowledge of zoonotic TB and with vitamin A supplementation (p <0.05). There was also significant difference in CD4% compared with undernutrition and in absolute CD4+ counts compared with drug resistance (p <0.05). Conversely, there was significant difference in CD4% and absolute CD4+ count when compared with maternal BCG vaccination, presence of maternal BCG Scar. Pearson correlation coefficient indicated weak negative relationship between CD4%, absolute CD4+ count and age. Also, weak positive relationship between HB and age. Both relationships were not significant (p <0.05). Conclusion: Undernutrition, gender, maternal BCG vaccination (with or without scaring) and age influence levels of CD4+ in TB patients.

BMI and sociodemographic characteristic among patients with tuberculosis attending a DOTS clinic at a tertiary care hospital in Kathmandu, Nepal

Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis is a serious public health threat in low- and middle-income countries. In tuberculosis, the sociodemographic aspects play a significant role in increasing the susceptibility to infection. The current study aimed to study the BMI and sociodemographic characteristic among patients with tuberculosis attending a DOTS clinic at a tertiary care hospital of Kathmandu. An observational descriptive cross sectional study using census sampling technique was conducted among 170 persons with tuberculosis coming for ATT drugs in Community Medicine OPD of Nepal Medical College Teaching Hospital. The information was obtained using self-constructed structured questionnaire from the study population. The information regarding socioeconomic characteristics, medical and family history, type and clinical presentation of tuberculosis and anthropometric measurement were taken. Out of 170 tuberculosis patient 93 had pulmonary tuberculosis, 71 had extrapulmonary tuberculosis and 6 had both. The different types of tuberculosis showed the association with occupation of respondents, family types, socioeconomic status, family size, BCG scar and social habits before tuberculosis. Weight loss and cough were most common clinical presentation among the participants whereas lymphnode and gastrointestinal tract were most common sites for extrapulmonary tuberculosis. According to BMI, 16.5% of the study population were underweight. Thus, the present study provides valuable information regarding association of sociodemographic factors with tuberculosis and nutritional status of persons with tuberculosis.

A Case–control Study on Risk Factors for Development of Tuberculous Meningitis in Adults

Abstract Introduction: Tuberculous meningitis remains the most severe and devastating form of tuberculosis with relatively severe morbidity and mortality. Risk factors for TB meningitis have not focused on the role of the BCG vaccine or social and food insecurity which are known to have a role in pulmonary TB. Methods: We prospectively conducted a Case-Control study among 65 patients with TB meningitis and 41 controls with other forms of meningitis. We evaluated the role of the BCG vaccine, the Household Food Insecurity Access Scale (HFIAS) and the Social Readjustment Rating Scale (SRRS) to look for food and social stress respectively. We also evaluated the known risk factors for TB meningitis including age, HIV co-infection, alcoholism, malignancies, use of immunosuppression, head injury among others. A bivariate followed by multivariate regression analysis was performed. Results: The presence of BCG scar was seen in 64.6 percent of patients with Tuberculous meningitis and 61.0 percent of control (P= 0.71). There was no difference in the size of the scars (P= 0.45) . Household food insecurity using the Household Food Insecurity Access Scale (HFIAS) ( a positive answer in any of the 9 items) was present in 16.9% of the patients in the TBM group and in 14.6% of the patients in the control group. (P= 0.75). Social stress assessed using the Social Readjustment Rating Score (< 150 suggest no social stress, 150 – 300 moderate social stress,> 300 high social stress) showed that a majority of the patients in both the groups reports no social stress. Only 9.8% of patients in the TBM group and 18.5% in the control group reports moderate presence of social stress whereas none of the patients had severe social stress. Logistic regression analysis suggested that only higher BMI was associated with lesser incidence of Tuberculous meningitis, odds ratio 0.83 (95% confidence interval of 0.73 – 0.930) and individuals performing clerical and unskilled and under-skilled jobs- odds ratio 0.13 (95% confidence interval of 0.02 – 0.93) had lower risk for TB Meningitis. Conclusions: In our sample of TB meningitis patients the BCG vaccine, food insecurity nor social stress appear to be risk factors. Bigger BMI and certain occupations appear to be possibly protective.

Frequency of absent BCG Scar in Babies Vaccinated with BCG

Objective; In a TB endemic country find the frequency and associations of absent BCG scar in babies vaccinated with BCG.
 Study Design; Interventional prospective cohort study.
 Palace and Duration of Study; Immunization centre at Paediatric department of Fauji Foundation Hospital, Lahore from Mar 2021 to Aug 2021
 Methodology; Infants with age ranging from 1day-1month, born at term with no antenatal, natal or post natal complications were selected by non-purposive convenient sampling and vaccinated by a single vaccinator using only one strain of BCG. Presence or absence of BCG scar was checked on their following visits for vaccinations at 6, 10 and 14 weeks of age and evaluated against different variables.
 Result; 540 infants were included in this study. 384 had a complete follow-up, of which 35(9.1%) did not develop a scar after vaccination. This absence of scar was evaluated against gender , birth weight , day of vaccination, type of feed and socio economic status and there was no statistically significant association as p-value was >0.05
 Conclusion; Probability of developing a BCG scar is independent of gender , birth weight , day of vaccination , type of feed and socioeconomic status. We suggest that babies who do not develop a scar should be revaccinated if they show poor response to TST after 6 months of ageas it can give rise to cross-protection against micro-organisms that might be unrelated totarget disease.

High-resolution ultrasonography for early diagnosis of neural impairment in seropositive leprosy household contacts.

Leprosy household contacts (HC) represent a high-risk group for the development of the disease. Anti-PGL-I IgM seropositivity also increases the risk of illness. Despite significant advances in leprosy control, it remains a public health problem; and early diagnosis of this peripheral neuropathy represents one of the main goals of leprosy programs. The present study was performed to identify neural impairment in leprosy HC by analyzing differences in high-resolution ultrasonographic (US) measurements of peripheral nerves between leprosy HC and healthy volunteers (HV). Seventy-nine seropositive household contacts (SPHC) and 30 seronegative household contacts (SNHC) underwent dermato-neurological examination and molecular analysis, followed by high-resolution US evaluation of cross-sectional areas (CSAs) of the median, ulnar, common fibular and tibial nerves. In addition, 53 HV underwent similar US measurements. The US evaluation detected neural thickening in 26.5% (13/49) of the SPHC and only in 3.3% (1/30) among the SNHC (p = 0.0038). The CSA values of the common fibular and tibial nerves were significantly higher in SPHC. This group also had significantly greater asymmetry in the common fibular and tibial nerves (proximal to the tunnel). SPHC presented a 10.5-fold higher chance of neural impairment (p = 0.0311). On the contrary, the presence of at least one scar from the BCG vaccine conferred 5.2-fold greater protection against neural involvement detected by US (p = 0.0184). Our findings demonstrated a higher prevalence of neural thickening in SPHC and support the role of high-resolution US in the early diagnosis of leprosy neuropathy. The combination of positive anti-PGL-I serology and absence of a BCG scar can identify individuals with greater chances of developing leprosy neuropathy, who should be referred for US examination, reinforcing the importance of including serological and imaging methods in the epidemiological surveillance of leprosy HC.

Prevalence of observed BCG scar in a cohort of health care workers from three Lusophone sub-Saharian African countries: cross-sectional comparative study

Prevalence of observed BCG scar in a cohort of health care workers from three Lusophone sub-Saharian African countries: cross-sectional comparative study

Determinants of QuantiFERON Plus-diagnosed tuberculosis infection in adult Ugandan TB contacts: A cross-sectional study.

The tuberculin skin test is commonly used to diagnose latent tuberculosis infection (LTBI) in resource-limited settings, but its specificity is limited by factors including cross-reactivity with BCG vaccine and environmental mycobacteria. Interferon-gamma release assays (IGRA) overcome this problem by detecting M. tuberculosis complex-specific responses, but studies to determine risk factors for IGRA-positivity in high TB burden settings are lacking. We conducted a cross-sectional study to determine factors associated with a positive IGRA by employing the QuantiFERON-TB® Gold-plus (QFT Plus) assay in a cohort of asymptomatic adult TB contacts in Kampala, Uganda. Multivariate logistic regression analysis with forward stepwise logit function was employed to identify independent correlates of QFT Plus-positivity. Of the 202 participants enrolled, 129/202 (64%) were female, 173/202 (86%) had a BCG scar, and 67/202 (33%) were HIV-infected. Overall, 105/192 (54%, 95% CI 0.48-0.62) participants had a positive QFT Plus result. Increased risk of QFT-Plus positivity was independently associated with casual employment/unemployment vs. non-casual employment (adjusted odds ratio (aOR) 2.18, 95% CI 1.01-4.72), a family vs. non-family relation to the index patient (aOR 2.87, 95% CI 1.33-6.18), living in the same vs. a different house as the index (aOR 3.05, 95% CI 1.28-7.29), a higher body mass index (BMI) (aOR per additional kg/m2 1.09, 95% CI 1.00-1.18) and tobacco smoking vs. not (aOR 2.94, 95% CI 1.00-8.60). HIV infection was not associated with QFT-Plus positivity (aOR 0.91, 95% CI 0.42-1.96). Interferon Gamma Release Assay positivity in this study population was lower than previously estimated. Tobacco smoking and BMI were determinants of IGRA positivity that were previously unappreciated.

THE RELATIONSHIP OF LONG-TERM REACTIVATION OF POST-VACCINATION SCAR AFTER IMMUNIZATION WITH BCG VACCINE WITH NONSPECIFIC AFFECTS

BCG is a unique vaccine. It was created and successfully used for specific prevention of tuberculosis. Reactivation of the BCG scar is a transient condition that occurs against the background of various diseases, capable of resolving itself, does not involve surgical intervention, but due to the low frequency of detected cases and the lack of pathogenetic justification for its occurrence requires dynamic observation.

Association between presence of Bacillus Calmette-Guerin vaccine scar and coronavirus disease 2019.

Bacillus Calmette-Guerin vaccine is administered for protection against tuberculosis and may also have beneficial effects against some viral respiratory tract infections. In this study, it was aimed to investigate the relationship between Bacillus Calmette-Guerin vaccination which is confirmed by BCG scar, and the frequency and course of Coronavirus disease 2019 (COVID-19). Among 490 patients, 400 patients who accepted to participate in the study were included. After the consent of patients, age, gender, body mass index, comorbidities, smoking, history, and the progress of COVID-19 of these patients were investigated; the presence and number of Bacillus Calmette-Guerin scars were recorded by a physician. Data from groups with and without COVID-19 history were compared. There was no relation between presence and number of the BCG scar and COVID-19 related hospitalization and intensive care unit admission. When groups with and without COVID-19 history compared, no statistically significant difference was found with the presence and number of Bacillus Calmette-Guerin scars (P > 0,05). No association was found between the presence or number of BCG scars and the frequency and course of COVID-19 in individuals with Bacillus Calmette-Guerin vaccination history confirmed by the presence of Bacillus Calmette-Guerin vaccine scars. Currently, the most important protection against COVID-19 is the COVID-19 vaccine.

THE SPECTRUM OF MACROPHAGE INHIBITORY FACTOR CYTOKINE RESPONSES IN PADIATRIC BCG VACCINEE

At most BCG vaccination in childhood is being finalized with scar formation. Absence of BCG scar formation few days post-vaccination can be a state of anergy. Though, gradual scar fade up may demonstrate a case of waning immunity. The present work was performed onto three groups of healthy children. Scar bearing BCG vaccinee child, non-scar bearing BCG vaccinee child and non-vaccinated child as controls. Age, scar size and macrophage inhibitory factor MIF cytokines were determined. A fraction of scar bearing BCG vaccinee were showing lower MIF concentration than normal controls. A state of waning cytokine responses in spite of the presence of scar. Likewise, a fraction of non-scar bearing BCG vaccinee were showing MIF concentrations lower than that of normal healthy controls ,a state of waning cytokine responses that parallels the waning of gross manifestation of the scar reactions. These findings point out the condition of heterogeneity or divergency of the immune response to BCG vaccines in childhood. MIF cytokine herd response were showing low moderate, and high responders in vaccinated children. The MIF cytokine herd response plots were of Gaussian distribution plots.

Prevalence of latent tuberculosis infection and incidence of active tuberculosis in school close contacts in Shanghai, China: Baseline and follow-up results of a prospective cohort study.

BackgroundThe management of latent tuberculosis infection (LTBI) is a key action for the realization of the “End tuberculosis (TB) Strategy” worldwide, and it is important to identify priority populations. In this prospective cohort study, we evaluated the prevalence of LTBI and incidence of active TB among close contacts and explored the suitable TB control strategy in schools.MethodsWe designed a cohort with 2 years of follow-up, recruiting freshman/sophomore TB patients’ close contacts from three administrative districts in Shanghai. These were chosen based on different levels of TB incidence reported in 2019. Questionnaires were included and all participants received both tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT) at baseline, then tracked the outcomes of them during the follow-up period.ResultsThe prevalence of LTBI was 4.8% by QFT. Univariate analysis showed that the risk of LTBI was higher in those contacting bacteriologically confirmed patients or did not have BCG scars, including smokers. The risk increased with poor lighting and ventilation conditions at contact sites. Multivariate analysis showed that those contacting with bacteriologically confirmed patients (OR=4.180; 95%CI, 1.164-15.011) or who did not have BCG scars (OR=5.054; 95%CI, 2.278-11.214) had a higher risk of being LTBI, as did the current smokers (OR=3.916; 95%CI, 1.508-10.168) and those who had stopped smoking (OR=7.491; 95%CI, 2.222-25.249). During the 2-year follow-up period, three clinically diagnosed cases of TB were recorded, the 2-year cumulative incidence was 0.4% (95%CI 0.1-1.2), the median duration for TB occurrence was 1 year, the incidence rate of active TB was 2.0 per 1000 person-years with a total of 1497.3 observation person-years. For those LTBI, no one initiated preventive treatment, in the QFT (+) cohort, 1 TB case was observed, 71 person-years with an incidence rate of 14.1 14.1 (95%CI 2.5-75.6) per 1000 person-years, in the TST (+++) cohort, 2 TB cases were observed 91.5 person-years with an incidence rate of 21.9 (95%CI 6.0-76.3) per 1000 person-years.ConclusionsThe results suggest that school close contacts are one of the key populations for LTBI management. Measures should be taken to further reduce the prevalence of LTBI and the incidence of active TB among them.