Romanus V, Svensson A, Hallander H O
Department of Epidemiology, National Bacteriological Laboratory, Stockholm, Sweden.
Tuber Lung Dis. 1992 Jun;73(3):150-61. doi: 10.1016/0962-8479(92)90149-E.
In April 1975, the mass vaccination of newborns against tuberculosis was replaced by selective vaccination of groups at risk. BCG coverage fell from more than 95% before 1974 to 1.8% between 1975 and 1982 and thereafter reached an average of 13.7% up to 1989. The cumulative incidence of tuberculosis before 5 years of age was estimated among children born in Sweden during periods of high, low and moderate increasing BCG coverage. The incidence figures per 100,000 children was 0.8, 3.9 and 2.9, respectively, for children born to Swedish parents and 2.6, 39.4 and 13.2, respectively, for those born to foreign parents. The observed incidence of tuberculosis among non-BCG vaccinated children born to Swedish parents was within the expected limits given by a prognostic model based on the natural change of the risk of infection. The effectiveness of the selective BCG vaccination programme, which was intensified after 1981 for the second generation of immigrants, was estimated to 0.82 (95% confidence interval 0.38, 0.95) assuming that there was no change of the risk of infection for children born to foreign parents over the period studied. From April 1975 to December 1989, tuberculosis was notified in 85 children born in Sweden during the same period, 7 of them were BCG vaccinated and 78 non-vaccinated, 45 were symptomatic, 3 of them with disseminated tuberculosis.
1975年4月，新生儿大规模结核病疫苗接种被针对高危人群的选择性疫苗接种所取代。卡介苗接种覆盖率从1974年前的95%以上降至1975年至1982年期间的1.8%，此后到1989年平均达到13.7%。对瑞典出生的儿童在卡介苗接种覆盖率高、低及中等增长期间5岁前结核病的累积发病率进行了估算。瑞典籍父母所生孩子每10万名儿童中的发病率分别为0.8、3.9和2.9，外籍父母所生孩子的发病率分别为2.6、39.4和13.2。瑞典籍父母所生未接种卡介苗儿童中观察到的结核病发病率在基于感染风险自然变化的预后模型给出的预期范围内。假设在所研究期间外籍父母所生孩子的感染风险没有变化，1981年后针对第二代移民加强的选择性卡介苗接种计划的有效性估计为0.82（95%置信区间0.38，0.95）。1975年4月至1989年12月期间，瑞典同期出生的85名儿童中通报了结核病，其中7名接种了卡介苗，78名未接种，45名有症状，其中3名患有播散性结核病。
