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Assessing the impact of different BCG vaccination strategies on severe childhood TB in low-intermediate prevalence settings
We estimated that the 100·5 million BCG vaccinations given to infants in 2002 will have prevented 29 729 cases of tuberculous meningitis (5th–95th centiles, 24 063–36 192) in children during their first 5 years of life, or one case for every 3435 vaccinations (2771–4177), and 11 486 cases of miliary tuberculosis (7304–16 280), or one case for every 9314 vaccinations (6172–13 729). The numbers of cases prevented would be highest in South East Asia (46%), sub-Saharan Africa (27%), the western Pacific region (15%), and where the risk of tuberculosis infection and vaccine coverage are also highest. At US$2–3 per dose, BCG vaccination costs US$206 (150–272) per year of healthy life gained.
BCG vaccination is a highly cost-effective intervention against severe childhood tuberculosis; it should be retained in high-incidence countries as a strategy to supplement the chemotherapy of active tuberculosis.
ser=10&_coverDate=12%2F31%2F1959&_rdoc=1&_fmt=high&_orig=article&_cdi=20179&_sort=v&_docanchor=&view=c&_ct=34&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=a215a56aa7eb0936167a868276ca62ed">BCG vaccination and tuberculosis in Birmingham: A study of notifications related to vaccination of children before leaving school Tubercle, Volume 40, Issue 6, December 1959, Pages 432-442 V.H. Springett Abstract SummaryBCG vaccination of Birmingham school children has reduced their tuberculosis notification rates by something between 0·5 and 0·7 per thousand per annum.Statistically, the evidence is of such a nature that it cannot be taken as establishing the value of BCG vaccination. Practically, and taken in conjunction with the strictly controlled Medical Research Council Trial, the evidence fully justifies the use of BCG in children about to leave school in Birmingham and similar communities. Financially, the cost BCG vaccination in Birmingham is less (and probably much less) than the estimated cost of dealing with the cases prevented. ser=10&_orig=article&_coverDate=12%2F31%2F1959&_sk=999599993&view=c&wchp=dGLbVtz-zSkzS&md5=3ac650f9d7522fc269921accaa66c808&ie=/sdarticle.pdf"> Purchase PDF (589 K) |
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Assessing the impact of different BCG vaccination strategies on severe childhood TB in low-intermediate prevalence settings