Determinants of BCG scarification among children in rural Guinea-Bissau: A prospective cohort study. Issue 10 (3rd October 2018)

• Record Type: Journal Article
• Authors: Funch, Katarina M.; Thysen, Sanne M.; Rodrigues, Amabelia; Martins, Cesario L.; Aaby, Peter; Benn, Christine S.; Fisker, Ane B.
• Is Part Of: Human vaccines & immunotherapeutics. Volume 14:Issue 10(2018)
• Page Start: 2434
• Page End: 2442
• Publication Date: 2018-10-03
• Subjects: Non-specific effects of vaccines -- heterologous immunity -- Bacillus Calmette-Guérin vaccine -- BCG-scar -- BCG strain -- vaccination technique; Vaccines -- Periodicals; 615.372
• DOI: 10.1080/21645515.2017.1421879
• Languages: English
• ISSNs: 2164-5515

Abstract

ABSTRACT: Background : Bacillus Calmette-Guérin (BCG) vaccination may have beneficial non-specific effects on child survival, the effects being stronger for children developing a scar. In a prospective cohort study, we examined determinants for not developing a BCG scar within 6 months of vaccination. Methods : Bandim Health Project (BHP) runs a Health and Demographic Surveillance System site in rural Guinea-Bissau. BHP provides BCG at monthly visits. We studied determinants for not developing a BCG scar using binomial regression models to obtain relative risks (RR). Results : From May 2012 until October 2014, BHP nurses vaccinated 2415 infants with BCG. We assessed BCG scar between 6 and 12 months of age for 2156 (89%) of these children and 2115 (98%) had developed a scar. In comparison, among 785 children BCG vaccinated elsewhere, 622 (79%) had a scar, the RR of not having a scar being 10.91 (7.52-15.85) compared with children vaccinated by BHP. Among children vaccinated by BHP, those receiving the Russian BCG strain were more likely not to develop a scar (RR = 2.98 (1.52–5.81)) compared with children receiving Danish BCG strain. Children with no post-injection wheal or a wheal <3 mm were more likely to not develop a scar (RR = 9.05 (3.69–22.20) and RR = 4.74 (1.96–11.45), respectively). Nutritional status and socioeconomic status were not associated with scarification. Conclusion : Vaccination technique and vaccine strain were associated with BCG scar development while nutritional status and socioeconomic status were not. Scarring rate may therefore be a better indicator of vaccination programme performance than coverage.