Awasthi S, Moin S
Department of Pediatrics, King George's Medical College, Lucknow. (UP), India.
Indian Pediatr. 1999 May;36(5):455-60.
To assess the protective effectiveness of BCG vaccination against tuberculous meningitis, while controlling for age, nutrition and socio-economic status, in children 1 month to 12 years of age.
Case-control study.
Secondary care referral and teaching hospital.
Cases were those conforming to the definition of tuberculous meningitis and controls were patients admitted after every third consecutive case included in the study from September 1995 till the end of August 1997 and who did not suffer from any central nervous system disorder.
Among the 192 cases and 70 controls, BCG scar was present in 57.8% and 75.7%, respectively. The crude odd's ratio (OR)for tuberculosis meningitis with a BCG scar was 0.44 (95% CI, .24-0.81; p = 0.008), while the adjusted OR was 0.53 (95% CI, 0.26-1.06; p value = 0.07) after controlling for weight, age, sex and place of residence. Higher weight for age and urban residence were associated with a decreased risk of tuberculous meningitis in the logistic model.
BCG vaccination offers protection against tuberculous meningitis. Since improvement in weight for age was associated with a decreased risk of disease, further studies are needed to evaluate the association, if any, between nutritional status and vaccine efficacy.
评估卡介苗接种对1个月至12岁儿童结核性脑膜炎的保护效果，同时控制年龄、营养状况和社会经济地位等因素。
病例对照研究。
二级医疗转诊和教学医院。
病例为符合结核性脑膜炎定义的患者，对照为1995年9月至1997年8月底期间，从纳入研究的每连续第三个病例之后入院且未患有任何中枢神经系统疾病的患者。
192例病例和70例对照中，有卡介苗疤痕的分别占57.8%和75.7%。有卡介苗疤痕的结核性脑膜炎患者的粗比值比（OR）为0.44（95%可信区间，0.24 - 0.81；p = 0.008），在控制体重、年龄、性别和居住地点后，调整后的OR为0.53（95%可信区间，0.26 - 1.06；p值 = 0.07）。在逻辑模型中，年龄别体重较高和居住在城市与结核性脑膜炎风险降低相关。
卡介苗接种可预防结核性脑膜炎。由于年龄别体重的改善与疾病风险降低相关，因此需要进一步研究以评估营养状况与疫苗效力之间是否存在关联（若有）。
