Pereira Susan M, Dantas Odimariles Maria Souza, Ximenes Ricardo, Barreto Mauricio L
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BA, Brazil.
Rev Saude Publica. 2007 Sep;41 Suppl 1:59-66. doi: 10.1590/s0034-89102007000800009.
The BCG vaccine has been in use since 1921, but still arouses controversy and uncertainties. The objective was to analyze the protective effect of the BCG vaccine in its first and second doses and the accompanying vaccination policies.
A systematic review of the literature in both English and Spanish was carried out, covering the period 1948 to 2006, using the PubMed database. The main search terms used included BCG vaccine, BCG efficacy, BCG and tuberculosis. The studies were grouped by design, with the main results from the clinic tests, case-control studies and meta-analyses presented separately.
The protective effect of the first dose of the BCG vaccine against tuberculosis in its miliary and meningeal forms is high. However, the results vary in relation to the pulmonary form of the disease, with some indicating zero effect and others levels of nearly 80%. Research is being carried out to develop new vaccines that could substitute the BCG or be used as a booster.
There are evidences that the protective effect of the BCG vaccine does not increase with a second dose. In spite of its limitations and the expectation that a new tuberculosis vaccine will be developed in the future, the BCG vaccine remains an important tool in controlling the harmful effects of tuberculosis, particularly in countries with medium or high incidence levels of the disease.
卡介苗自1921年开始使用，但仍引发争议和不确定性。目的是分析卡介苗第一剂和第二剂的保护效果以及相应的疫苗接种政策。
利用PubMed数据库，对1948年至2006年期间的英文和西班牙文文献进行系统综述。主要检索词包括卡介苗、卡介苗效力、卡介苗与结核病。研究按设计分组，临床试验、病例对照研究和荟萃分析的主要结果分别呈现。
卡介苗第一剂对粟粒型和脑膜型结核病的保护效果很高。然而，对于该疾病的肺部形式，结果有所不同，一些表明无效果，而另一些则接近80%。正在开展研究以开发可替代卡介苗或用作加强剂的新疫苗。
有证据表明，卡介苗第二剂不会增加其保护效果。尽管存在局限性，且期望未来开发出新的结核病疫苗，但卡介苗仍然是控制结核病有害影响的重要工具，特别是在结核病发病率中等或较高的国家。
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