@article{Roy:2014:10.1136/bmj.g4643,
author = {Roy, A and Eisenhut, M and Harris, RJ and Rodrigues, LC and Sridhar, S and Habermann, S and Snell, L and Mangtani, P and Adetifa, I and Lalvani, A and Abubakar, I},
doi = {10.1136/bmj.g4643},
journal = {BMJ: British Medical Journal},
title = {Effect of BCG vaccination against Mycobacterium tuberculosis infection in children: systematic review and meta-analysis},
url = {http://dx.doi.org/10.1136/bmj.g4643},
volume = {349},
year = {2014}
}

Download

TY  - JOUR
AB  - Objectives To determine whether BCG vaccination protects against Mycobacterium tuberculosis infection as assessed by interferon γ release assays (IGRA) in children.Design Systematic review and meta-analysis. Searches of electronic databases 1950 to November 2013, checking of reference lists, hand searching of journals, and contact with experts.Setting Community congregate settings and households.Inclusion criteria Vaccinated and unvaccinated children aged under 16 with known recent exposure to patients with pulmonary tuberculosis. Children were screened for infection with M tuberculosis with interferon γ release assays.Data extraction Study results relating to diagnostic accuracy were extracted and risk estimates were combined with random effects meta-analysis.Results The primary analysis included 14 studies and 3855 participants. The estimated overall risk ratio was 0.81 (95% confidence interval 0.71 to 0.92), indicating a protective efficacy of 19% against infection among vaccinated children after exposure compared with unvaccinated children. The observed protection was similar when estimated with the two types of interferon γ release assays (ELISpot or QuantiFERON). Restriction of the analysis to the six studies (n=1745) with information on progression to active tuberculosis at the time of screening showed protection against infection of 27% (risk ratio 0.73, 0.61 to 0.87) compared with 71% (0.29, 0.15 to 0.58) against active tuberculosis. Among those infected, protection against progression to disease was 58% (0.42, 0.23 to 0.77).Conclusions BCG protects against M tuberculosis infection as well as progression from infection to disease.
AU  - Roy,A
AU  - Eisenhut,M
AU  - Harris,RJ
AU  - Rodrigues,LC
AU  - Sridhar,S
AU  - Habermann,S
AU  - Snell,L
AU  - Mangtani,P
AU  - Adetifa,I
AU  - Lalvani,A
AU  - Abubakar,I
DO  - 10.1136/bmj.g4643
PY  - 2014///
SN  - 0959-535X
TI  - Effect of BCG vaccination against Mycobacterium tuberculosis infection in children: systematic review and meta-analysis
T2  - BMJ: British Medical Journal
UR  - http://dx.doi.org/10.1136/bmj.g4643
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000340206000002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - https://www.bmj.com/content/349/bmj.g4643
UR  - http://hdl.handle.net/10044/1/21285
VL  - 349
ER  - 

Download