BCG vaccine and leprosy household contacts: Protective effect and probability to becoming sick during follow-up

Gomes, Rafaela Resende; Antunes, Douglas Eulálio; Santos, Diogo Fernandes dos; Sabino, Elaine Fávaro Pípi; Oliveira, Dulcinéia Bernardes; Goulart, Isabela Maria Bernardes

doi:10.1016/j.vaccine.2019.08.067

Cited by 16 publications

(25 citation statements)

References 22 publications

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“…Various studies have implied that the BCG vaccine reduces severe diseases related to other infections other than TB [10] , [11] . For instance, a review by Moorlag and his colleagues indicated that BCG vaccination improved antibody production against viral infections [11] .…”

Section: Introductionmentioning

confidence: 99%

The effect of Bacillus Calmette–Guérin (BCG) vaccination in preventing severe infectious respiratory diseases other than TB: Implications for the COVID-19 pandemic

Yitbarek

Abraham

Girma³

et al. 2020

Vaccine

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The rapid spread of the Coronavirus pandemic and its significant health and social impact urges the search for effective and readily available solutions to mitigate the damages. Thus, evaluating the effectiveness of existing vaccines like Bacillus Calmette–Guérin (BCG) has attracted attention. The aim of this review was e vidence synthesis on the effect of BCG vaccine in preventing severe infectious respiratory disease including COVD-19, but not tuberculosis. We considered studies conducted on human participants of any study design from any country setting that were published in Enlgish. We did a systematic literature search in MEDLINE, Scopus and Google scholar databases and a free search on Google. The identified studies were appraised and relevant data were extracted using Joanna Briggs Institute tools. The extracted findings were synthesized with tables and narrative summary. Nine studies met the inclusion criteria. The findings indicated that BCG vaccine has a strong protective effect against both upper and lower acute respiratory tract infections. For instance in countries with universal BCG vaccination policy, the incidence of COVID-19 was lower compared to the counterparts. Addtionally, BCG vaccine was found to protect against infections like lethal influenza A virus, pandemic influenza (H1N1), and other acute respiratory tract infections. BCG improved the human body’s immune response involving antigen-specific T cells and memory cells. It also induced adaptive functional reprogramming of mononuclear phagocytes that induce protective effects against different respiratory infections other than tuberculosis. In countries with universal BCG vaccination, the incidence and death from acute respiratory viral infection including COVID – 19 is significantly low. However, there is an urgent need for further evidence from well-designed studies to understand the possible role of BCG vaccination over time and across age groups, its possible benefits in special populations such as health workers and cost-savings related to a policy of universal BCG vaccination.

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Section: Introductionmentioning

confidence: 99%

The effect of Bacillus Calmette–Guérin (BCG) vaccination in preventing severe infectious respiratory diseases other than TB: Implications for the COVID-19 pandemic

Yitbarek

Abraham

Girma³

et al. 2020

Vaccine

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“…132 Furthermore, the evidence regarding the effectiveness of BCG revaccination is conflicting, because of the wide variation in study outcomes. 23,46,52,54,128,133,134 When assessing other immunoprophylactic agents, BCG plus heat-killed M. leprae was found not to have an additional effect in leprosy prevention when compared with BCG alone. 51,53,54 Even if BCG plus heat-killed M. leprae provided additional protection, further development of a vaccine containing killed M. leprae is challenging because mass production would need to occur in armadillos or in immune-compromised mice.…”

Section: Immunoprophylaxismentioning

confidence: 99%

“…126 This increase of cases after immunoprophylaxis administration in the first year is consistent with other studies. 48,51,[127][128][129] Therefore, Richardus et al concluded that BCG vaccination followed by SDR as a routine intervention is not recommended in leprosy control.…”

Section: Bcg and Sdr-pep Combinedmentioning

confidence: 99%

“…56 Additionally, after the administration of BCG and other immunoprophylactic agents for leprosy prevention, a relative increase in the number of new (paucibacillary) leprosy patients is seen in the first follow-up year. 48,51,[127][128][129] A possible explanation for this is that BCG is catalyzing the existing anti-mycobacterial immunity in people infected with M. leprae, resulting in the clinical appearance of tuberculoid leprosy after BCG vaccination. 48,127 Gormus and Meyers described the reasoning for the doses chosen in trials with integral mycobacterial vaccines as arbitrary.…”

Section: Immunoprophylaxismentioning

confidence: 99%

“…Considering the above results, contact screening followup is especially important in the first period after BCG administration, as a relatively large number of new patients presents three months post-vaccination. 48,51,[127][128][129] This may also count for other immunoprophylactic agents.…”

Section: Immunoprophylaxismentioning

confidence: 99%

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<p>The State of Affairs in Post-Exposure Leprosy Prevention: A Descriptive Meta-Analysis on Immuno- and Chemo-Prophylaxis</p>

Schoenmakers

Mieras

Budiawan³

et al. 2020

RRTM

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Objective: Annually, over 200,000 people are diagnosed with leprosy, also called Hansen's disease. This number has been relatively stable over the past years. Progress has been made in the fields of chemoprophylaxis and immunoprophylaxis to prevent leprosy, with a primary focus on close contacts of patients. In this descriptive meta-analysis, we summarize the evidence and identify knowledge gaps regarding post-exposure prophylaxis against leprosy. Methods: A systematic literature search according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was conducted by searching the medical scientific databases Cochrane, Embase, Pubmed/MEDLINE, Research Gate, Scopus and Web of Science on Jan. 22, 2020, using a combination of synonyms for index terms in four languages: "leprosy" and "population" or "contacts" and "prevention" or "prophylaxis." Subsequently, Infolep.org and Google Scholar were searched and the "snowball method" was used to retrieve other potentially relevant literature. The found articles were screened for eligibility using predetermined inclusion and exclusion criteria. Results: After deduplication, 1,515 articles were screened, and 125 articles were included in this descriptive meta-analysis. Immunoprophylaxis by bacillus Calmette-Guérin (BCG) vaccination is known to provide protection against leprosy. The protection it offers is higher in household contacts of leprosy patients compared with the general population and is seen to decline over time. Contact follow-up screening is important in the first period after BCG administration, as a substantial number of new leprosy patients presents three months postvaccination. Evidence for the benefit of re-vaccination is conflicting. The World Health Organization (WHO) included BCG in its Guidelines for the Diagnosis, Treatment and Prevention of Leprosy by stating that BCG at birth should be maintained in at least all leprosy high-burden regions. Literature shows that several vaccination interventions with other immunoprophylactic agents demonstrate similar or slightly less efficacy in leprosy risk reduction compared with BCG. However, most of these studies do not exclusively focus on post-exposure prophylaxis. Two vaccines are considered future candidates for leprosy prophylaxis: Mycobacterium indicus pranii (MiP) and LepVax. For chemoprophylaxis, trials were performed with dapsone/acedapsone, rifampicin, and ROM, a combination of rifampicin, ofloxacin, and minocycline. Single-dose rifampicin is favored as post-exposure prophylaxis, abbreviated as SDR-PEP. It demonstrated a protective effect of 57% in the first two years after administration to contacts of leprosy patients. It is inexpensive, and adverse events are rare. The risk of SDR-PEP inducing rifampicin resistance is considered negligible, but continuous monitoring in accordance with WHO policies should be encouraged. The integration of contact screening and SDR-PEP administration into different leprosy control programs was found to be feasible and well accep...

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BCG vaccination induces enhanced humoral responses in elderly individuals

et al. 2023

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BCG vaccine and leprosy household contacts: Protective effect and probability to becoming sick during follow-up

Cited by 16 publications

References 22 publications

The effect of Bacillus Calmette–Guérin (BCG) vaccination in preventing severe infectious respiratory diseases other than TB: Implications for the COVID-19 pandemic

The effect of Bacillus Calmette–Guérin (BCG) vaccination in preventing severe infectious respiratory diseases other than TB: Implications for the COVID-19 pandemic

<p>The State of Affairs in Post-Exposure Leprosy Prevention: A Descriptive Meta-Analysis on Immuno- and Chemo-Prophylaxis</p>

BCG vaccination induces enhanced humoral responses in elderly individuals

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