BCG vaccination scar associated with better childhood survival in Guinea-Bissau

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BCG vaccination scar associated with better childhood survival in Guinea-Bissau. / Roth, Adam; Gustafson, Per; Nhaga, Alexandro; Djana, Queba; Poulsen, Anja; Garly, May-Lill; Jensen, Henrik; Sodemann, Morten; Rodriques, Amabelia; Aaby, Peter.

In: International Journal of Epidemiology, Vol. 34, No. 3, 2005, p. 540-547.

Research output: Contribution to journalArticle

Harvard

Roth, A, Gustafson, P, Nhaga, A, Djana, Q, Poulsen, A, Garly, M-L, Jensen, H, Sodemann, M, Rodriques, A & Aaby, P 2005, 'BCG vaccination scar associated with better childhood survival in Guinea-Bissau', International Journal of Epidemiology, vol. 34, no. 3, pp. 540-547. https://doi.org/10.1093/ije/dyh392

APA

Roth, A., Gustafson, P., Nhaga, A., Djana, Q., Poulsen, A., Garly, M-L., ... Aaby, P. (2005). BCG vaccination scar associated with better childhood survival in Guinea-Bissau. International Journal of Epidemiology, 34(3), 540-547. https://doi.org/10.1093/ije/dyh392

CBE

Roth A, Gustafson P, Nhaga A, Djana Q, Poulsen A, Garly M-L, Jensen H, Sodemann M, Rodriques A, Aaby P. 2005. BCG vaccination scar associated with better childhood survival in Guinea-Bissau. International Journal of Epidemiology. 34(3):540-547. https://doi.org/10.1093/ije/dyh392

MLA

Vancouver

Author

Roth, Adam ; Gustafson, Per ; Nhaga, Alexandro ; Djana, Queba ; Poulsen, Anja ; Garly, May-Lill ; Jensen, Henrik ; Sodemann, Morten ; Rodriques, Amabelia ; Aaby, Peter. / BCG vaccination scar associated with better childhood survival in Guinea-Bissau. In: International Journal of Epidemiology. 2005 ; Vol. 34, No. 3. pp. 540-547.

RIS

TY - JOUR

T1 - BCG vaccination scar associated with better childhood survival in Guinea-Bissau

AU - Roth, Adam

AU - Gustafson, Per

AU - Nhaga, Alexandro

AU - Djana, Queba

AU - Poulsen, Anja

AU - Garly, May-Lill

AU - Jensen, Henrik

AU - Sodemann, Morten

AU - Rodriques, Amabelia

AU - Aaby, Peter

PY - 2005

Y1 - 2005

N2 - BACKGROUND: Recent studies have suggested that Bacille Calmette-Guerin (BCG) vaccination may have a non-specific beneficial effect on infant survival and that a BCG scar may be associated with lower child mortality. No study has previously examined the influence of BCG vaccination on cause of death. METHODS: Two cohorts (A and B) were used to describe the mortality pattern for children with and without BCG scar and to determine specific causes of death. In cohort A (n = 1813), BCG scar was assessed at 6 months of age and as previously described children with a BCG scar had lower mortality over the next 12 months than children with no BCG scar. In cohort B, 1617 children aged 3 months to 5 years of age had their BCG scar status assessed in a household-based survey and mortality was assessed during a 12-month period. Causes of death were determined by verbal autopsy (VA) and related to BCG scar status in a cause-specific hazard function. RESULTS: Controlling for background factors associated with mortality, there was lower mortality for children with a BCG scar than without in cohort B, the mortality ratio (MR) being 0.45 (95% CI 0.21-0.96). Exclusion of children exposed to TB did not have any impact on the result. In a combined analysis of cohorts A and B, the MR was 0.43 (95% CI 0.28-0.65) controlling for background factors. There were no large differences in distribution of the five major causes of death (malaria, pneumonia, acute diarrhoea, chronic diarrhoea, and meningitis/encephalitis) according to BCG scar status in the two cohorts. Having a BCG scar significantly reduced the risk of death from malaria [MR 0.32 (95% CI 0.13-0.76)]. CONCLUSIONS: A BCG scar is a marker of better survival among children in countries with high child mortality. BCG vaccination may affect the response to several major infections including malaria.

AB - BACKGROUND: Recent studies have suggested that Bacille Calmette-Guerin (BCG) vaccination may have a non-specific beneficial effect on infant survival and that a BCG scar may be associated with lower child mortality. No study has previously examined the influence of BCG vaccination on cause of death. METHODS: Two cohorts (A and B) were used to describe the mortality pattern for children with and without BCG scar and to determine specific causes of death. In cohort A (n = 1813), BCG scar was assessed at 6 months of age and as previously described children with a BCG scar had lower mortality over the next 12 months than children with no BCG scar. In cohort B, 1617 children aged 3 months to 5 years of age had their BCG scar status assessed in a household-based survey and mortality was assessed during a 12-month period. Causes of death were determined by verbal autopsy (VA) and related to BCG scar status in a cause-specific hazard function. RESULTS: Controlling for background factors associated with mortality, there was lower mortality for children with a BCG scar than without in cohort B, the mortality ratio (MR) being 0.45 (95% CI 0.21-0.96). Exclusion of children exposed to TB did not have any impact on the result. In a combined analysis of cohorts A and B, the MR was 0.43 (95% CI 0.28-0.65) controlling for background factors. There were no large differences in distribution of the five major causes of death (malaria, pneumonia, acute diarrhoea, chronic diarrhoea, and meningitis/encephalitis) according to BCG scar status in the two cohorts. Having a BCG scar significantly reduced the risk of death from malaria [MR 0.32 (95% CI 0.13-0.76)]. CONCLUSIONS: A BCG scar is a marker of better survival among children in countries with high child mortality. BCG vaccination may affect the response to several major infections including malaria.

KW - non-specific effects of vaccines

KW - cause of death

KW - verbal autopsy

KW - infant mortality

KW - BCG

U2 - 10.1093/ije/dyh392

DO - 10.1093/ije/dyh392

M3 - Article

VL - 34

SP - 540

EP - 547

JO - International Journal of Epidemiology

T2 - International Journal of Epidemiology

JF - International Journal of Epidemiology

SN - 1464-3685

IS - 3

ER -