Berendsen Mike L T, Smits Jeroen, Netea Mihai G, van der Ven André
Department of Internal Medicine, Radboud Center for Infectious Diseases, Radboud University Medical Center, Nijmegen, The Netherlands; Global Data Lab, Institute for Management Research, Radboud University, Nijmegen, The Netherlands.
Global Data Lab, Institute for Management Research, Radboud University, Nijmegen, The Netherlands.
EBioMedicine. 2016 Jun;8:341-348. doi: 10.1016/j.ebiom.2016.05.010. Epub 2016 May 12.
Bacillus Calmette-Guérin (BCG) vaccination possesses effects on health beyond its target disease, the so called "non-specific effects". We evaluate these effects, as well as the effect of timing of BCG and other vaccinations, on stunting in Sub-Saharan African (SSA) children under five.
We use a Big Data design, including cross-sectional data for 368,450 children from 33 SSA countries. Logistic regression analysis is used with control factors at child, mother, household and context level.
Overall, BCG vaccination did not affect stunting in SSA children (OR 1.00 [0.98-1.03]). Timing of BCG vaccination was of importance (βtime=0.067 [0.061-0.073]): compared to unvaccinated children, BCG was associated with lower odds on stunting for children vaccinated early in life (OR 0.92 [0.89-0.94]) and higher odds for children vaccinated later in infancy (OR 1.64 [1.53-1.76]). Similar findings were done for diphtheria-tetanus-pertussis (DTP)1 and measles vaccination, and when hemoglobin concentration was used as outcome variable.
We found a general time-dependent pattern of non-specific effects of vaccination, with positive associations for vaccinations given early in life and negative associations for vaccinations given later in infancy. If confirmed in further research, our findings may provide a new perspective on the non-specific effects of vaccination.
卡介苗（BCG）接种除了对其目标疾病有作用外，还对健康具有所谓的“非特异性作用”。我们评估这些作用以及卡介苗和其他疫苗接种时间对撒哈拉以南非洲（SSA）五岁以下儿童发育迟缓的影响。
我们采用大数据设计，包括来自33个SSA国家的368450名儿童的横断面数据。使用逻辑回归分析，并控制儿童、母亲、家庭和环境层面的因素。
总体而言，卡介苗接种对SSA儿童的发育迟缓没有影响（比值比1.00 [0.98 - 1.03]）。卡介苗接种时间很重要（β时间 = 0.067 [0.061 - 0.073]）：与未接种疫苗的儿童相比，卡介苗与生命早期接种疫苗的儿童发育迟缓几率较低相关（比值比0.92 [0.89 - 0.94]），而与婴儿期后期接种疫苗的儿童发育迟缓几率较高相关（比值比1.64 [1.53 - 1.76]）。对白喉 - 破伤风 - 百日咳（DTP）1和麻疹疫苗接种以及将血红蛋白浓度用作结果变量时，也有类似发现。
我们发现了疫苗接种非特异性作用的一般时间依赖性模式，生命早期接种疫苗有正相关，婴儿期后期接种疫苗有负相关。如果在进一步研究中得到证实，我们的发现可能为疫苗接种的非特异性作用提供新的视角。
