Sinha D P, Bang F B
Lancet. 1976 Sep 11;2(7985):531-4. doi: 10.1016/s0140-6736(76)91791-8.
After B.C.G. vaccination of a group of tuberculin-negative children in West Bengal, India, 197 have been retested with tuberculin. 35-5% showed a definitely positive reaction. Only 15% showed no response to B.C.G. When compared by weight for age, the rate of positivity of those below 60% of the Harvard standard was significantly lower than of those above 80%. Those between 60 and 80% were similar to those above 80%. However, when the group was subdivided according to protein and calorie nutrition as measured by arm muscle and fat cross-sectional areas, the difference was striking. The tuberculin-test response was grossly impaired in those who were primarily severely protein deficient (kwashiorkor type), significantly depressed in those who were both severely protein and severely calorie deficient (marasmic-washiorkor type), and not depressed in those who were severely calorie deficient but normal or low in protein (marasmic type). It is suggested that clear distinction between different types of nutritional deficiency in a given geographic area is of direct relevance in planning mass vaccination programmes in that area.
在印度西孟加拉邦对一组结核菌素阴性儿童进行卡介苗接种后，对其中197名儿童进行了结核菌素复查。35.5%的儿童出现明确的阳性反应。只有15%的儿童对卡介苗无反应。按年龄别体重比较，低于哈佛标准60%的儿童阳性率显著低于高于80%的儿童。60%至80%之间的儿童与高于80%的儿童相似。然而，当根据通过手臂肌肉和脂肪横截面积测量的蛋白质和热量营养状况对该组进行细分时，差异显著。主要严重蛋白质缺乏（夸希奥科型）的儿童结核菌素试验反应严重受损，严重蛋白质和严重热量均缺乏（消瘦-夸希奥科型）的儿童反应明显降低，而严重热量缺乏但蛋白质正常或偏低（消瘦型）的儿童反应未降低。建议在特定地理区域明确区分不同类型的营养缺乏对于该地区大规模疫苗接种计划的规划具有直接相关性。
