BCG vaccination: Effects on the patterns of pediatric leprosy

Abstract

Introduction: Leprosy in pediatric population continues to remain as one of the major public health problems in India. BCG vaccination has been implicated in producing some protection against leprosy. Objectives: The present study intended to find out the patterns of leprosy in the pediatric age group (<12 years) and to determine the proportion of paucibacillary (PB) and multibacillary (MB) leprosy cases among the BCG-vaccinated and nonvaccinated groups. Methodology: It is a cross-sectional study among patients with leprosy up to the age of 12 years attending a tertiary care hospital in Eastern India by comprehensive history taking and through clinical examination. The history of BCG vaccination was enquired and the BCG scar was looked for to determine the BCG-vaccinated and nonvaccinated group. After collecting the data in a predesigned case sheet, the data were analyzed. Result: Of the 137 patients included in this study, 71.53% belonged to the 11–12 years age, 27.74% the 5–10 years age, and 1 patient the <5 year age group. The sex ratio was 1:1.63. PB leprosy was more common than MB leprosy. Smear positivity, deformity, and reaction were not very frequent. Among the vaccinated patients, the ratio of PB and MB leprosy was 5.3:1, while in the nonvaccinated group the ratio was 1.2:1. Data analysis showed that the proportion of MB leprosy was statistically significant in the nonvaccinated group than in the vaccinated group ( p = 0.0352). Conclusion: Our study pointed that BCG vaccination might have a role in enhancing the cell-mediated immunity (CMI).

Relationship Between BCG Vaccination History and the Incidence of Leprosy in Children: A Literature Review

“…A study examining the effectiveness of the BCG vaccine in children in India found a relationship between the history of BCG vaccination and the incidence of leprosy in children (p= 0.02). This study also found that PB leprosy was most common in the age group <12 years and the proportion of MB leprosy was statistically significant in the unvaccinated group compared to the vaccinated group (19). These results are in line with studies conducted from four leprosy endemic in Brazil showing that more leprosy sufferers who had not received the BCG vaccine were detected as MB-type leprosy patients compared to PB-type leprosy patients.…”

“…Vaccine studies have utilized live or killed whole mycobacterium, such as Bacille Calmette-Guérin (BCG), Indian cancer research center (ICRC) bacilli, and Mycobacterium weither alone or in combination with killed Mycobacterium leprae. Additionally, there is evidence that BCG vaccination may modify CMI, as there were fewer vaccinated individuals with advanced leprosy cases compared to unvaccinated individuals (19).…”

Leprosy: A Review of Epidemiology, Clinical Diagnosis, and Management

“…However, currently, BCG is the only vaccine administered to prevent leprosy [ 94 , 95 ]. In eastern India, a study was performed on patients with leprosy up to the age of 12 years attending a tertiary care hospital [ 96 ]. The nonvaccinated group had a significantly higher proportion of MB leprosy cases than the BCG-vaccinated group ( p =0.0352).…”

Leprosy: A clinical review

“…38,43 For this, it is necessary to systematically search for patients in endemic areas, investigate household or close contacts of the patient and offer free, immediate and specific treatment. 44 Smith 45 observed that the use of chemoprophylaxis with dapsone and acedapsone is effective in reducing the incidence of leprosy, particularly among home contacts, who have a higher risk of developing disease. Chemoprophylaxis for contacts is promising, and the drug of choice is now the rifampicin, 46 which can prevent up to 57% of cases in the first two years.…”