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Revaccination with Bacillus Calmette-Guerin (BCG) vaccine does not reduce morbidity from malaria in African children

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Author

  • Amabelia Rodrigues
  • Joanna Armstrong Schellenberg
  • Adam Roth
  • Christine Stabell Benn
  • Peter Aaby
  • Brian Greenwood

Summary, in English

BACKGROUND: Studies in West Africa and elsewhere have suggested that Bacillus Calmette-Guerin (BCG) vaccine given at birth is beneficial for child survival. It is possible that this effect is mediated partly through an effect on malaria, a hypothesis supported by animal studies. We investigated whether revaccination with BCG at 19 months of age reduced morbidity from malaria. METHOD: In the capital of Guinea-Bissau, between January and November 2003, children who had previously received BCG vaccination and who did not have a strong reaction to tuberculin were individually randomised to either receive revaccination with BCG at the age of 19 months or to be a control. Episodes of malaria were recorded during the 2003 malaria transmission season through passive case detection at health centres in the study area and at the national hospital. Cross-sectional surveys were carried out at the beginning and at the end of the rainy season. RESULTS: Incidence rates of first episodes of malaria associated with any level of parasitaemia were 0.16 episodes per child-year among 713 revaccinated children and 0.12 among 720 control children [incidence rate ratio (IRR) = 1.37; 95% confidence intervals (CI): 0.84-2.25]. Results were similar when the diagnosis of malaria was based on the presence of parasitaemia >5000 parasites/microl (IRR = 1.30; 95% CI: 0.61-2.77). The incidence of all-cause hospitalisation was higher among BCG-revaccinated children than among controls (IRR = 2.13; 95% CI: 1.10-4.13). There were no significant differences in the prevalence of parasitaemia between the two groups of children at cross-sectional surveys. CONCLUSION: We found no evidence that BCG revaccination reduces morbidity from malaria.

Publishing year

2007

Language

English

Pages

224-229

Publication/Series

Tropical Medicine & International Health

Volume

12

Issue

2

Document type

Journal article

Publisher

Wiley-Blackwell

Topic

  • Microbiology in the medical area

Keywords

  • malaria morbidity
  • BCG revaccination
  • children
  • revaccination par le BCG
  • morbidité due à la malaria
  • enfants
  • revacunación BCG
  • morbilidad por malaria
  • niños

Status

Published

Research group

  • Clinical Microbiology, Malmö

ISBN/ISSN/Other

  • ISSN: 1365-3156