Department of Epidemiology Research, Statens Serum Institut, Copenhagen S, Denmark.
Department of Infectious Disease Immunology, Statens Serum Institut, Copenhagen S, Denmark.
Thorax. 2014 Sep;69(9):851-6. doi: 10.1136/thoraxjnl-2014-205688. Epub 2014 Jun 26.
The BCG vaccine's ability to prevent Mycobacterium tuberculosis infection (MTI) remains highly debated. In Greenland, BCG vaccination was introduced in 1955, but was temporarily discontinued (1991-1996) due to nationwide policy changes. The study aimed to use the transient stop in BCG vaccination to evaluate the effect of vaccination on MTI prevalence and TB incidence.
MTI study: A cross-sectional study (2012), comprising East Greenlanders born during 1982-2006, evaluated the effect of BCG vaccination on MTI prevalence; a positive interferon γ release assay defined an MTI case. Associations were estimated using logistic regression. TB study: a cohort study covering the same birth cohorts with follow-up until 2012 evaluated the vaccine's effect on TB incidence. A personal identifier allowed for follow-up in the TB notification system. Associations were estimated using Cox regression.
MTI study: Included 953 participants; 81% were BCG-vaccinated; 29% had MTI, 23% among vaccinated and 57% among non-vaccinated. BCG vaccination reduced the odds of MTI, OR 0.52 (95% CI 0.32 to 0.85), p=0.01. Vaccine effectiveness against MTI was 20%. TB study: Included 1697 participants followed for 21,148 person-years. 6% were notified with TB, 4% among vaccinated and 11% among non-vaccinated. BCG vaccination reduced the risk of TB, HR 0.50 (95% CI 0.26 to 0.95), p=0.03, yielding a vaccine effectiveness of 50%.
BCG vaccination was effective in reducing both MTI and TB disease among children and young adults in a TB high-endemic setting in Greenland.
卡介苗（BCG）疫苗预防结核分枝杆菌感染（MTI）的能力仍存在较大争议。在格陵兰，BCG 疫苗于 1955 年引入，但由于全国政策变化，1991-1996 年期间曾暂停使用。本研究旨在利用 BCG 疫苗接种的短暂中断，评估接种疫苗对 MTI 患病率和结核病发病率的影响。
MTI 研究：一项横断面研究（2012 年）纳入了 1982-2006 年期间出生的东格陵兰人，评估了 BCG 疫苗接种对 MTI 患病率的影响；干扰素-γ释放试验阳性定义为 MTI 病例。使用逻辑回归估计关联。TB 研究：一项队列研究涵盖了相同的出生队列，并随访至 2012 年，评估了疫苗对结核病发病率的影响。个人标识符可用于在结核病报告系统中进行随访。使用 Cox 回归估计关联。
MTI 研究：共纳入 953 名参与者；81%接受了 BCG 疫苗接种；29%患有 MTI，接种组中有 23%，未接种组中有 57%。BCG 疫苗接种降低了 MTI 的发病风险，OR 0.52（95%CI 0.32-0.85），p=0.01。BCG 疫苗对 MTI 的有效性为 20%。TB 研究：共纳入 1697 名参与者，随访 21148 人年。6%被诊断为结核病，接种组中有 4%，未接种组中有 11%。BCG 疫苗接种降低了结核病的发病风险，HR 0.50（95%CI 0.26-0.95），p=0.03，疫苗有效性为 50%。
在格陵兰结核病高度流行地区，BCG 疫苗接种对儿童和青少年的 MTI 和结核病均有预防效果。
