巴西累西腓地区关于卡介苗复种预防结核病的病例对照研究。
A case-control study of protection against tuberculosis by BCG revaccination in Recife, Brazil.
作者信息
Dantas O M S, Ximenes R A de A, de Albuquerque M de F P M, da Silva N L C L, Montarroyos U R, de Souza W V, Pereira T C C, Campelo A R L, Rodrigues L C
机构信息
Department of Mother and Child Health, Federal University of Pernambuco, Recife, Brazil.
出版信息
Int J Tuberc Lung Dis. 2006 May;10(5):536-41.
SETTING
Metropolitan region of Recife, Brazil.
OBJECTIVE
To estimate the additional protection against tuberculosis (TB) provided by a second dose of bacille Calmette-Guérin (BCG) vaccine.
DESIGN
Case-control study. Cases were cases of TB newly diagnosed by the TB control programme, independent of clinical form. Three matched neighbourhood controls were selected using a systematic routine, starting from the case's address. The matching was within the age groups 7-9, 10-14 and 15-19 years.
RESULTS
Analysis was conducted among 169 cases and 477 controls. For the efficacy of BCG revaccination against TB overall, matched (crude) vaccine effectiveness (VE) was -3 (95% CI -50-29) and matched (adjusted) VE was 8 (95% CI -77-52).
CONCLUSIONS
This study suggests that a second dose of BCG does not offer additional protection. Revaccination should not be offered. As large numbers of subjects are already vaccinated and vaccine appears to offer some protection in older subjects, further studies with larger sample sizes could investigate the potential efficacy of revaccination with BCG in the age group > or = 15 years.
背景
巴西累西腓大都市区。
目的
评估第二剂卡介苗（BCG）疫苗对结核病（TB）的额外保护作用。
设计
病例对照研究。病例为结核病控制项目新诊断的结核病病例，不考虑临床类型。从病例住址开始，采用系统常规方法选取三名匹配的社区对照。匹配在7至9岁、10至14岁和15至19岁年龄组内进行。
结果
对169例病例和477名对照进行了分析。总体而言，BCG复种对结核病的有效性方面，匹配（粗）疫苗效力（VE）为-3（95%可信区间-50至29），匹配（调整）VE为8（95%可信区间-77至52）。
结论
本研究表明，第二剂BCG疫苗不能提供额外保护。不应进行复种。由于大量人群已经接种疫苗，且疫苗似乎在年龄较大的人群中提供了一定保护，因此进一步开展更大样本量的研究可以调查BCG复种在≥15岁年龄组中的潜在效力。
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