BCG vaccination and severity of childhood tuberculous meningitis
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《神经病学神经外科学杂志》
Correspondence to:
Dr V Rajshekhar
Department of Neurological Sciences, Christian Medical College, Vellore, India; rajshekhar@cmcvellore.ac.in
BCG vaccination may lessen the severity of, rather than completely prevent, serious forms of tuberculosis
Keywords: BCG vaccination; tuberculosis; tuberculous meningitis; vaccination
In this issue of the journal (see pages 1550–4), Kumar et al report on the efficacy of bacillus Calmette Guerin (BCG) vaccination in favourably altering the course and outcome of tuberculous meningitis (TBM) in children. The value of BCG vaccination for preventing tuberculosis has been debated since its introduction nearly eight decades ago. Several trials, cohort studies, and case control studies have failed to provide a definitive answer to this contentious issue. A recent meta-analysis revealed that the protective effect of BCG vaccination in infants was only around 50% against all forms of tuberculosis.1 It has been suggested that although BCG vaccination is not highly effective in preventing the illness, it does play a role in reducing the severity of the more serious forms of the disease such as TBM.2 The authors of the present report set out to study this premise and also to document the presentation of the disease in vaccinated children. The strength of their work lies in the prospective collection of their data. The authors’ data suggest that children who had been vaccinated had a milder form of the disease and consequently had a better short term outcome than those who had not
REFERENCES
Colditz GA, Berkey CS, Mosteller F, et al. The efficacy of bacillus Calmette-Guerin vaccination of new borns and infants in the prevention of tuberculosis: meta-analysis of the published literature. Pediatrics 1995;96:29–35.
Filho VW, de Castilho EA, Rodrigues LC, et al. Effectiveness of BCG against tuberculous meningitis. A case control study in Sao Paulo, Brazil. Bull WHO 1990;68:69–74.(V Rajshekhar)
Dr V Rajshekhar
Department of Neurological Sciences, Christian Medical College, Vellore, India; rajshekhar@cmcvellore.ac.in
BCG vaccination may lessen the severity of, rather than completely prevent, serious forms of tuberculosis
Keywords: BCG vaccination; tuberculosis; tuberculous meningitis; vaccination
In this issue of the journal (see pages 1550–4), Kumar et al report on the efficacy of bacillus Calmette Guerin (BCG) vaccination in favourably altering the course and outcome of tuberculous meningitis (TBM) in children. The value of BCG vaccination for preventing tuberculosis has been debated since its introduction nearly eight decades ago. Several trials, cohort studies, and case control studies have failed to provide a definitive answer to this contentious issue. A recent meta-analysis revealed that the protective effect of BCG vaccination in infants was only around 50% against all forms of tuberculosis.1 It has been suggested that although BCG vaccination is not highly effective in preventing the illness, it does play a role in reducing the severity of the more serious forms of the disease such as TBM.2 The authors of the present report set out to study this premise and also to document the presentation of the disease in vaccinated children. The strength of their work lies in the prospective collection of their data. The authors’ data suggest that children who had been vaccinated had a milder form of the disease and consequently had a better short term outcome than those who had not
REFERENCES
Colditz GA, Berkey CS, Mosteller F, et al. The efficacy of bacillus Calmette-Guerin vaccination of new borns and infants in the prevention of tuberculosis: meta-analysis of the published literature. Pediatrics 1995;96:29–35.
Filho VW, de Castilho EA, Rodrigues LC, et al. Effectiveness of BCG against tuberculous meningitis. A case control study in Sao Paulo, Brazil. Bull WHO 1990;68:69–74.(V Rajshekhar)