Department of Pediatrics, West China Second Hospital, Sichuan University, Chengdu, People's Republic of China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Chengdu, China.
Department of Pediatric Respiratory Medicine, The Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325027, China.
Int J Infect Dis. 2022 Aug;121:113-119. doi: 10.1016/j.ijid.2022.04.023. Epub 2022 Apr 14.
Evidence varies regarding the efficacy of Bacillus Calmette-Guérin (BCG) vaccine. Data on protection by BCG vaccination against severe tuberculosis (TB) among children in China remain unclear.
We conducted a case-based, multicenter retrospective study at three children's hospitals in China. Sociological factors affecting BCG vaccination and risk factors associated with disease types were analyzed using a multivariable model.
A total 1701 children with active TB were enrolled. Children who were younger, female, residing in a rural area, living in the western regions, and with no BCG vaccination history were at higher risk of developing severe TB. Children with a BCG scar had significantly lower risk for severe TB (odds ratio [OR] 0.59, 95% confidence interval [CI] 0.51-0.67). Children with no BCG scar but who were vaccinated at birth still had lower risk of severe TB types, such as tuberculous meningitis (OR 0.88, 95% CI 0.80-0.97) and miliary TB (OR 0.77, 95% CI 0.69-0.87).
Neonatal BCG vaccination could be an effective means to control TB. In the absence of a new, more effective TB vaccine, our results lend support to continued use of the BCG vaccine in China.
卡介苗（BCG）疫苗的疗效证据不一。中国儿童接种卡介苗预防重症结核病（TB）的数据仍不清楚。
我们在中国的三家儿童医院进行了一项基于病例的多中心回顾性研究。使用多变量模型分析了影响卡介苗接种的社会学因素和与疾病类型相关的危险因素。
共纳入 1701 例活动性 TB 患儿。年龄较小、女性、居住在农村、居住在西部地区且无卡介苗接种史的患儿发生重症 TB 的风险更高。有卡介苗疤痕的患儿发生重症 TB 的风险显著降低（比值比 [OR] 0.59，95%置信区间 [CI] 0.51-0.67）。虽然没有卡介苗疤痕，但在出生时接种过疫苗的儿童，其发生结核性脑膜炎（OR 0.88，95%CI 0.80-0.97）和粟粒性 TB（OR 0.77，95%CI 0.69-0.87）等重症 TB 类型的风险仍较低。
新生儿 BCG 接种可能是控制 TB 的有效手段。在没有新的、更有效的 TB 疫苗的情况下，我们的结果支持继续在中国使用 BCG 疫苗。
