Tuberculin sensitivity among children vaccinated with BCG under universal immunization programme

Chadha, V. K.; Jaganath, P. S.; Kumar, Prahlad

doi:10.1007/bf02829815

Cited by 16 publications

(15 citation statements)

References 12 publications

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“…5,17,20 Also, data from several studies in India suggest that BCG vaccination may not pose a major problem in the interpretation of TST results. 14,24,25 Recent nationwide tuberculin surveys in India, involving more than 100,000 children, have also shown the BCG does not substantially affect the estimation of annual risk of infection. 24,25 However, BCG might adversely affect TST results in other populations, depending on BCG strain used, timing of vaccination, frequency, and time elapsed since vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…14,24,25 Recent nationwide tuberculin surveys in India, involving more than 100,000 children, have also shown the BCG does not substantially affect the estimation of annual risk of infection. 24,25 However, BCG might adversely affect TST results in other populations, depending on BCG strain used, timing of vaccination, frequency, and time elapsed since vaccination. 38 It is therefore important to consider these issues carefully before selecting the appropriate test.…”

Section: Discussionmentioning

confidence: 99%

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Alternatives to the tuberculin skin test: Interferon-γ assays in the diagnosis of Mycobacterium Tuberculosis infection

Pai¹

2005

Indian J Med Microbiol

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The need for alternatives to the tuberculin skin testThe tuberculin skin test (TST) was, until recently, the only test available for the diagnosis of LTBI. [2][3][4][5][6][7] The TST measures delayed type hypersensitivity response to the purified protein derivative (PPD). A major limitation of PPD is the fact that AbstractFor nearly a century, there were no alternatives to the tuberculin skin test (TST) for diagnosing latent tuberculosis infection. Because of advances in immunology and genomics, for the first time, an alternative has emerged in the form of T cell based interferon-g (IFN-γ) assays, a new generation of in vitro tests of cellular immunity. These assays measure cell mediated immune response by quantifying IFN-γ released by T cells in response to stimulation by Mycobacterium tuberculosis antigens. Although early versions of IFN-γ assays used purified protein derivative (PPD) as the stimulating antigen, newer versions use antigens that are significantly more specific to M. tuberculosis. These specific antigens include ESAT-6 and CFP-10. These proteins, encoded by genes located within the region of difference 1 (RD1) segment of the M. tuberculosis genome, are more specific to M. tuberculosis than PPD because they are not shared with any BCG substrains or several nontuberculous mycobacterial species. A review of current evidence on the performance of IFN-γ assays and TST suggests that both the TST and IFN-γ assays have advantages and limitations, and both tests appear to be useful at this time. The emergence of IFN-γ assays is a much anticipated, welcome development that has, for the first time, increased the choice of tests available for diagnosing latent tuberculosis infection. Because both tests have their strengths and limitations, the decision to select one over the other will depend on the population, the goal of testing, and the resources available. To fully evaluate the utility of IFN-γ assays in high burden countries such as India, long-term cohort studies are needed to determine the association between positive IFN-γ results and the subsequent risk of active disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Alternatives to the tuberculin skin test: Interferon-γ assays in the diagnosis of Mycobacterium Tuberculosis infection

Pai¹

2005

Indian J Med Microbiol

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“…2 Bacillus Calmette-Guerin (BCG) is a live attenuated vaccine given routinely to all newborn infants in developing countries under Universal Immunization Program. 3 Reconstituted 0.1 ml of BCG vaccine contains 0.1-0.4 million live viable mycobacterium bovis bacilli of Danish 1331 strain. Efficacy ranging from 0 to 80%, BCG vaccine is credited to reduce the incidence of disseminated tuberculosis and tubercular meningitis in vaccinated children.…”

Section: Weeks) Infantsmentioning

confidence: 99%

Immunogenicity and safety of early vs delayed BCG vaccination in moderately preterm (31–33 weeks) infants

Saroha

Faridi

Batra

et al. 2015

Human Vaccines & Immunotherapeutics

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Minimum gestation at which infant can be given BCG (Bacillus Calmette-Guerin) vaccine safely at birth is not clearly defined. Our objectives were the following: to compare Mantoux test after 6 months of BCG immunization in moderately preterm babies (31-33 weeks) vaccinated at birth and 34 weeks post conception age and to compare in above groups:(a) Interferon -gamma (IFN-g) levels in BCG vaccinated infants who did not react to Mantoux test (b) Local BCG reaction at 6, 10, 14 weeks and 6 months (c) Complications of BCG vaccination. Interventional, randomized comparative trial. Moderately preterm infants (31-33 weeks), 90 in each group. At birth, 180 moderately preterm infants were recruited and randomly allocated into 2 groups. Two ml venous blood was drawn for estimation of IFN-g levels. Infants were given BCG vaccine within 72 hours of birth and followed up after 2, 4, 6, 10, 14 weeks and 6 months (group 1). Infants were recruited at birth and held up till 34 weeks post conception age (group 2) and then given BCG vaccine and followed up similarly as group 1. At each visit, local BCG reaction, any local or unusual complication and anthropometric measurements were noted. At six months, Mantoux test was done and 2 ml venous blood sample was collected for IFN-g levels post vaccination. Presence or absence of BCG local reaction, PPD conversion rates and complications were analyzed using Chi square or Fisher's exact test. IFN-g levels were analyzed by ANOVA. In all 117 infants could be followed till 6 months after BCG immunization in 2 groups, and Mantoux test was positive in 38.4% of them. The rate of Mantoux test positivity was similar irrespective of the age of giving BCG immunization (group 1-39.1% vs group 2-37.5%; p > 0.05). IFN-g levels were significantly raised at 6 months in 60% (n D 21/41) and 65% (n D 15/27) Mantoux negative infants in group 1 and group 2 respectively. The sequence and order of local BCG reaction at 2, 4, 6, 10, 14 weeks and 6 months was in the form of papule, pustule, ulcer, scab and scar. Scar was formed in 94.2% and 89.5% infants in group 1 and group 2 respectively. One infant in group 1 showed abortive reaction (0.85%). Only 3.4% of infants developed lymphadenopathy and was similar in both the groups. Moderately preterm infants (31-33 weeks) exhibited 98.3% immunogenicity after BCG immunization at birth and can be safely vaccinated without any risk of severe complications.

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“…In a study done by Miret P et al cutoff of ≥5 mm and in a study by Chadha ≥20 mm was taken as positive. 7 The PPD used were also of different strengths ranging from 1TU PPD RT 23to 5 TU PPD RT 23. (Table 6).…”

Section: Discussionmentioning

confidence: 99%

Tuberculin sensitivity among inmates of children’s home

Challa¹,

Sowmya²,

Jayamala³

2017

Int J Contemp Pediatr

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Background: Tuberculin sensitivity and its relationship to nutritional status in inmates of children's home.Methods: Tuberculin sensitivity was checked in 180 apparently healthy orphan children and its relationship with nutritional status, previous vaccination status was studied. setting: children's home run by NGOs participants: all inmates of children's home aged 2-15 years who meet inclusion and exclusion criteria.Results: Out of 180 apparently healthy children 27 (15%) were tuberculin positive. 109 (60.5%) were undernourished children out of which 15 (55.56%) were tuberculin positive. Out of 71 normal nourished children, 12 (44.4%) were tuberculin positive. BCG scar was present in 120 (66.6%) children out of which 19 were tuberculin positive and BCG scar was absent in 60% children out of which 8 were tuberculin positive. 8 children had history of contact with TB and 6 of them were tuberculin positive.Conclusions: Tuberculin sensitivity testing using 5 TU PPD-RT23 is a simple feasible method to screen inmates of children home at the time of entry and it is not influenced by nutritional status or previous BCG vaccination. Early diagnosis and treatment of TB will go a long way in reducing the burden of TB in our country.

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Tuberculin sensitivity among children vaccinated with BCG under universal immunization programme

Cited by 16 publications

References 12 publications

Alternatives to the tuberculin skin test: Interferon-γ assays in the diagnosis of Mycobacterium Tuberculosis infection

Alternatives to the tuberculin skin test: Interferon-γ assays in the diagnosis of Mycobacterium Tuberculosis infection

Immunogenicity and safety of early vs delayed BCG vaccination in moderately preterm (31–33 weeks) infants

Tuberculin sensitivity among inmates of children’s home

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