天津市汉沽区儿童卡介苗免疫接种效果分析

目的了解天津市汉沽辖区近3年内结核菌素儿童卡介苗接种的免疫效果。方法对4 281名已初种卡介苗儿童结核菌素（PPD）试验结果进行分析。结果 3个月～3岁、4～5岁和6～7岁3个年龄组PPD试验阳性率,2008、2009和2010年分析为97.3%～85.7%、97.1%～83.3%和97.2%～90.0%。结论汉沽近3年儿童卡介苗接种免疫效果较好,接种质量较高。抓好新生儿卡介苗初种质量,是提高卡介苗接种成功率的关键。     

淮北市新生儿卡介苗接种质量监测

卡介苗接种是我国儿童计划免疫的主要内容，是预防儿童结核病的重要措施之一。卡介苗接种后12”阳转率是考核和评价卡介苗接种质量与免疫成功率的重要指标。现就淮北市200名新生儿卡介苗接种质量监测结果进行分析，以评价卡介苗接种工作质量。     

不同浓度卡介苗接种后免疫效果观察

目的探讨不同浓度卡介苗接种后的免疫效果。方法采取随机抽样的研究方法,将正常新生儿分成2组,对照组278例,实验组为300例,用改变菌液浓度来增加接种的有效卡介苗量。具体为对照组每支卡介苗溶解稀释时用0.5ml注射用水配制,取0.1ml菌液接种,每支卡介苗接种5人;实验组每支卡介苗溶解稀释时用0.75ml注射用水配制,取0.15ml菌液接种,每支卡介苗接种5人。将两组新生儿卡介苗接种免疫效果进行比较。结果实验组卡介苗阳转率明显高于对照组(P(0.05)。结论本研究实验组的方法保证了新生儿卡介苗接种的有效量,从而提高了卡介苗接种后PPD的阳转率及卡疤成功率,对临床工作具有指导意义。     

两种剂型卡介苗免疫效果观察

两种剂型卡介苗免疫效果观察饶小燕，钟玉梅，邓友华，谢赞才，陈育昌，谢小强，李辉肾为了解我市新生儿卡介苗接种的免疫效果，１９９１年６月在全市七县一区开展新生儿和一周岁内的婴儿接种卡介苗后的结素阳转率调查，发现我市卡介苗免疫成功率很低，仅２５．３％。为此...     

影响新生儿卡介苗接种阳转率的因素分析

[目的]评价新生儿卡介苗接种后免疫效果(阳转率的水平),分析影响其阳转率的因素.[方法]对1996年1月～2005年12月在我院预防保健科做结核菌素试验的5344名满3个月～12个月婴幼儿的资料进行统计分析.[结果]1996年1月～2000年12月的2610名婴幼儿,查验结果显示卡介苗阳转率平均为75.55%,有效卡痕形成率92.3%;2001年1月～2005年12月的2734名婴幼儿,查验结果显示卡介苗阳转率为68.98%,有效卡痕形成率94.5%;两组结果均低于卡介苗平均阳转率85%的指标,说明卡介苗接种质量较差.[结论]要加强新生儿卡介苗接种技术的培训和普及,严格规范操作及注意事项,提高接种质量.结核菌素试验也应规范操作和正确判断结果,准确反映卡介苗的阳转率.     

吐哈油田新生儿卡介苗免疫效果监测

接种卡介苗是我国控制结核病的重要措施之一，了解吐哈油田新生儿卡介苗免疫状况，评价卡介苗接种质量和效果，为控制卡介苗免疫的影响因素、提高卡介苗免疫成功率提供依据。     

不同等级2所医院新生儿卡介苗接种效果及影响因素研究

目的了解常州市不同等级的2所医院新生儿卡介苗接种效果及其影响因素,为提高接种质量和人群免疫水平提供依据.方法 选择1个市级医院,1个县级医院作为哨点,监测2013年1~12月不同批次菌苗对符合条件新生儿的接种情况,3个月后进行结核菌素试验试验(PPD),观察硬结纵横径和直径,评价接种效果;采用Logistic回归模型,对接种效果进行多因素回归分析. 结果共接种卡介苗新生儿2254例,接种成功2090人,接种成功率92.7%.单因素分析显示,不同单位,季节,疫苗批次卡介苗接种成功率差异有统计学意义(P<0.05);金坛市人民医院接种成功率为95.15%,明显大于市妇幼保健院90.17%,差异有统计学意义(P < 0.05); 经组间比较,秋季接种成功率明显高于冬季(χ²=14.080, P = 0.000).疫苗批号201003a015-1接种成功率明显低于其他各批号,批号201003a012-2接种成功率明显低于批号201101a004-1和201012a083-2,差异均有统计学意义(均P = 0.000).多因素logistic回归分析,疫苗批号(OR=1.754,95%CI:1.477~2.084)是卡介苗接种成功的影响因素. 结论常州市市县不同等级医院新生儿卡介苗接种成功率均较高,疫苗不同批次是影响接种成功的影响因素.     

新生儿卡介苗接种质量及免疫效果分析

目的了解汕头市龙湖区新生儿卡介苗接种质量、评价接种效果。方法对2007年5月～2010年9月在汕头市龙湖区接种卡介苗的新生儿并在我院做卡介苗接种效果监测的新生儿卡介菌纯蛋白衍生物试验(PPD试验)结果进行统计分析。结果 2007～2010年新生儿接种率98.49%,接种后12周末PPD阳转率87.39%,卡痕率为89.95%,其中卡疤直径≥3 mm者1 554例,占47.35%,<3 mm者1 728例,占52.65%,卡疤平均直径为2.45 mm,结素反应平均直径6.59 mm,无卡疤者330例。有卡疤组PPD试验阳性率92.95%,无卡疤组PPD试验阳性率37.58%,两组PPD试验阳性率差异有统计学意义(2=825.78,p<0.005)。结论龙湖区卡介苗接种效果较好。但仍存在着不足之处,应加强学习,改进接种技术,保证接种质量。     

常州市不同等级两所医院新生儿卡介苗接种效果及影响因素研究

目的了解常州市不同等级的两所医院新生儿卡介苗接种效果及其影响因素,为提高接种质量和人群免疫水平提供依据。方法选择1个市级医院、1个县级医院作为哨点,监测2013年1-12月不同批次菌苗对符合条件新生儿的接种情况,3个月后进行结核菌素试验(PPD),观察硬结纵横径和直径,评价接种效果;采用Logistic回归模型,对接种效果进行多因素回归分析。结果共接种卡介苗新生儿2 254例,接种成功2 090人,接种成功率92.7%。单因素分析显示,不同单位、季节、疫苗批次卡介苗接种成功率差异有统计学意义(P0.05);金坛市人民医院接种成功率为95.15%,明显大于市妇幼保健院(90.17%),差异有统计学意义(P0.05);经组间比较,秋季接种成功率(97.94%)明显高于冬季(90.76%,χ2=14.080,P=0.000)。疫苗批号201003a015-1接种成功率明显低于其他各批号,批号201003a012-2接种成功率明显低于批号201101a004-1和201012a083-2,差异均有统计学意义(均P=0.000)。多因素logistic回归分析,疫苗批号(OR=1.754,95%CI:1.477~2.084)是卡介苗接种成功的影响因素。结论常州市市县不同等级医院新生儿卡介苗接种成功率均较高,疫苗不同批次是影响接种成功的影响因素。     

湛江市1999～2001年部分0～7岁儿童结核菌素试验结果分析

[目的 ]了解湛江市部分儿童卡介苗接种效果 ,制定今后免疫策略。 [方法 ] 1999年 11月至 2 0 0 1年 11月对到湛江市卫生防疫站接种的 991名 0～ 7岁儿童进行调查 ,用常规方法进行结核菌素试验。 [结果 ]有卡介苗接种史的占95 86% ,卡疤率为 97 2 6% ;结核菌素试验阳性率有卡介苗接种史者为 86 42 % ,未接种卡介苗或接种史不详者为19 5 1%。年龄越小阳性率越高。全部儿童均无强阳性者。 [结论 ]湛江市部分儿童结核菌的感染率不高 ,要开展定期查漏 ,尽早补种卡介苗 ,进一步巩固和提高儿童对结核菌的免疫力。     

广州市新生儿卡介苗接种质量监测

目的　了解 2 0 0 1～ 2 0 0 3年广州市新生儿卡介苗接种质量。方法　对 2 0 0 1～ 2 0 0 3年广州市越秀、荔湾、东山、海珠区 2 4个接种单位的新生儿卡介苗接种报表和质量监测结果进行分析。结果　新生儿卡介苗接种率、接种后1 2周结核菌素纯蛋白衍化物 (TB -PPD)阳转率、PPD反应平均直径、卡痕率、卡痕平均直径等指标均较稳定。结论　广州市新生儿卡介苗接种工作质量较高并保持稳定。     

宣城市500名婴儿卡介苗接种效果评价

目的评价分析宣城市卡介苗接种效果,探讨提高卡介苗接种工作质量的相关方法。方法 2007～2009年、2011年期间随机抽取宣城市10个接种点的500名1岁以内健康婴儿,在接种卡介苗12w后,测量卡痕径值及进行BCG-PPD阳转试验。结果 500名婴儿的卡痕率为97.40%,结核菌素试验阳转率87.80%;不同性别、城乡接种点的婴儿结核菌素试验阳性率差异无统计学意义(P值均小于0.05);不同接种月龄婴儿间结核菌素试验阳性率无统计学差异(χ2=0.55,P=0.76)。卡痕径值≥4mm的婴儿结核菌素试验阳性率高于卡痕径值4mm的婴儿。结论宣城市卡介苗接种卡痕率、阳转率达到国家免疫规划要求,接种质量比较稳定。新生儿出生1个月后、3个月内接种卡介苗,对接种质量无明显影响。卡痕径值大小,对评价接种质量具有一定参考意义。     

安徽六安市婴儿卡介苗接种效果评价及相关因素分析

目的评价婴儿卡介苗（BCG）接种质量及效果,分析其影响因素。方法在全市8县区中抽取1周岁以内且接种BCG 12周以上的健康婴儿,调查接种时间,测量卡痕径值、进行结核菌素（BCG-PPD）试验并观察结果。结果共调查800名婴儿卡痕率为97.00%,PPD试验阳性率80.13%;单因素分析显示,出生后BCG接种时间（χ2=6.695,P=0.010）、卡痕直径（χ2=61.250,P=0.000）、住址不同（χ2=73.148,P=0.000）的PPD试验阳性率差异有统计学意义（P〈0.05）,不同性别差异无统计学意义（χ2=3.650,P=0.056）。多因素Logistic回归分析显示,卡痕直径〈3 mm与≥3 mm的PPD阳性率差异有统计学意义（P〈0.05）,提示卡痕直径≥3 mm时接种更成功（OR=0.413,95%CI：0.263-0.649）。结论六安市卡介苗接种质量总体较好。卡痕直径、出生后接种时间,医务人员的接种技能是卡介苗接种效果的影响因素。     

Sensitivity and specificity of the BCG scar reading

OBJECTIVE: To validate the BCG scar as a marker of BCG vaccination status. METHODS: A cross-sectional survey was carried out among 53,348 schoolchildren aged 6-14 years who underwent BCG scar examination as part of a large BCG vaccine trial taking place in the city of Manaus, Brazil. Results of BCG scar reading were compared with information on vaccine status of their vaccination cards or provided by parents or guardians. Double-reading was performed in a sub-sample. Data analysis was conducted using Stata 7 and Kappa coefficient. RESULTS: Of 52,348 schoolchildren studied, vaccine status information from parents/guardian letters was available for 29,254 and from vaccination cards for 4,947. There was found a high agreement between the double-readings of the scars (Kappa=0.81). When the agreement between letter and card information was the gold standard, the sensitivity of BCG scar readings was 96.6% (95%CI 96.0-97.1) and the specificity was 71.1% (95%CI 55.7-83.7). The sensitivity was 96.1%, 97.3% and 95.3% for children vaccinated up to one month of age, four months and one year, respectively. CONCLUSIONS: Sensitivity and specificity did not show an association with the child's age at the scar reading. BCG scar was a good marker of BCG vaccination status regardless of age - from the first years of life up to 14 years old.     

Scar size and effectiveness of Bacillus Calmette Guerin (BCG) vaccination in the prevention of tuberculosis and leprosy: a case-control study

BACKGROUND: The study was undertaken to estimate the effectiveness of BCG vaccination in relation to scar size in the prevention of tuberculosis and leprosy. METHODS: The present study was designed as hospital-based pair-matched case-control study and was carried out at Government Medical College Hospital, Nagpur, Maharashtra, India. It included 877 cases of tuberculosis and 292 cases of leprosy (diagnosed by WHO criteria), born onwards 1962. Each case was pair-matched with one control for age, sex and socio-economic status. BCG vaccination status was assessed by examination for the presence of BCG scar, immunisation records if available and information from subjects/parents of children. Subjects uncertain about BCG vaccination were not included. The diameter of the BCG scar was measured both across and along the arm in millimeters using a plastic ruler. The average was then calculated. RESULTS: A significant protective association between BCG vaccination and tuberculosis (OR=0.38, 95% CI 0.31-0.47) and leprosy (OR = 0.38, 95% CI 0.26-0.55) was observed. The overall vaccine effectiveness (VE) was 62% (95% CI 53-69) against tuberculosis and 62% (95% CI 45- against leprosy. Vaccine effectiveness against tuberculosis and leprosy was non-significantly greater in the group who had BCG scar size < or =5 mm as compared to subjects who had BCG scar size > 5 mm. Thus there was no clear association between BCG scar size and its effectiveness. CONCLUSION: The current study did not identify any significant association between BCG scar size and its effectiveness against tuberculosis or leprosy.     

卡介苗接种2～4年后卡痕、结素试验及结素阳性维持率的比较

我们对生后种卡介苗做结素试验的婴儿2～4年后回访做第二次结素试验。结果表明:种卡介苗后2年、3年和4年3组的OT阳转维持率分别为73.7％、67.3％和63.4％,3组之间无显著性差异,而与第1次OT阳性率比较有明显下降;第1次OT均径与卡痕均径之间有相关关系,卡痕在以后一段时间内仍有明显缩小,但仅有3％的儿童卡痕难以辨认。本结果说明卡介苗引起的迟发性皮肤变态反应,其OT阳转维持率在1年内明显下降,而在以后的2～4年中无明显变化。     

The relationship between nutritional and sociodemographic factors and the likelihood of children in the Dominican Republic having a BCG scar.

OBJECTIVES: To critically assess the prevalence among schoolchildren 6 to 9 years of age throughout the Dominican Republic of a bacille Calmette-Guérin (BCG) vaccination scar, and to examine the relationship between nutritional and sociodemographic factors and the likelihood of having a BCG scar. METHODS: This correlational study used the database of the Second National Census on Height and Weight of Elementary School First Grade Students, which was conducted in the Dominican Republic August 2001-May 2002, to provide a critical assessment of BCG coverage nationwide. The Census information for the children included the presence of BCG scar, their nutritional status, and basic demographic data. We developed a new sociodemographic indicator, the "Rosa Index," to examine the potential influence of poverty and other environmental characteristics on scar presence. We used logistic regression models to predict the presence of a BCG scar. RESULTS: An overall BCG scar prevalence of 55.3% (85,644/154,887) was found. Malnourished children were less likely to have a BCG scar than were children with adequate nutritional status (odds ratio = 0.91; 95% confidence interval: 0.87, 0.95, P < 0.05). Children who were 7-9 years old were less likely to have a BCG scar than were children 6 years old. Children in the areas of the country more than two hours' driving distance from the capital city of Santo Domingo more often exhibited lower BCG scar prevalence levels than did children in Santo Domingo. A higher Rosa Index (better level of socioeconomic characteristics) was correlated with higher BCG scar prevalence values (r = 0.54, P < 0.05). CONCLUSIONS: Our study findings indicate that BCG coverage appears to be inadequate for schoolchildren in the Dominican Republic. Nevertheless, the presence of a scar in a higher proportion of younger children suggests that coverage has improved in recent years. More programmatic and economic emphasis needs to be placed on extending early BCG vaccination coverage to the areas of the country where vaccination coverage is lower, and on examining the potential role that poverty may have on vaccination effectiveness.     

Sensitivity and specificity of BCG scar reading among HIV-infected children

BCG scar has been used as an indicator of vaccination with BCG in the past, but the validity of scar among HIV-positive children is still unknown. The validity of BCG scar reading among such children was estimated, using three different gold standards. The sensitivity ranged from 81.3% (95%-CI: 78.0–84.2) to 91.6% (95%-CI: 88.4–94.0), when the gold standards were, respectively, information from the adult responsible for the child and the vaccination card. The specificity ranged from 90.5% (95% CI: 81.6–95.5) to 94.1% (95% CI: 87.7–97.4), when the gold standards were, respectively, the vaccination card and information from the adult responsible for the child. Reading of BCG scar was shown to be a good indicator for vaccination in the past, among HIV-infected children.     

Safety of the intradermal Copenhagen 1331 BCG vaccine in neonates in Durban, South Africa

OBJECTIVE: To evaluate the safety of the intradermal Copenhagen BCG vaccine in neonates at different levels of delivery and neonatal units of the Durban Functional Region and surrounding regions. METHODS: A prospective study was carried out over a two-year period between July 1997 and June 1999. All neonates who had been vaccinated with the intradermal vaccine were evaluated at immunization clinics six weeks after immunization, or earlier if adverse effects occurred. FINDINGS: In total, 9763 neonates were examined: in 95.4% the vaccination scar had healed and 1.5% had no visible scar. Adverse events occurred in 3.1%. The proportion of neonates with no visible vaccination scars decreased over the study period, as did the number with adverse events. The lowest rate of adverse events and the highest rates of healed vaccination scars were seen in the tertiary hospital and regional and district hospitals that were in close proximity to the academic centre involved in this study. CONCLUSIONS: In the study sites, the transition from the percutaneous to intradermal route of administration of BCG vaccine was successful and took place without incurring unacceptably high rates of adverse events. To minimize adverse events, however, it is essential to continue training health personnel involved in implementing intradermal BCG vaccination programmes.     

BCG vaccination scar associated with better childhood survival in Guinea-Bissau

BACKGROUND: Recent studies have suggested that Bacille Calmette-Guerin (BCG) vaccination may have a non-specific beneficial effect on infant survival and that a BCG scar may be associated with lower child mortality. No study has previously examined the influence of BCG vaccination on cause of death. METHODS: Two cohorts (A and B) were used to describe the mortality pattern for children with and without BCG scar and to determine specific causes of death. In cohort A (n = 1813), BCG scar was assessed at 6 months of age and as previously described children with a BCG scar had lower mortality over the next 12 months than children with no BCG scar. In cohort B, 1617 children aged 3 months to 5 years of age had their BCG scar status assessed in a household-based survey and mortality was assessed during a 12-month period. Causes of death were determined by verbal autopsy (VA) and related to BCG scar status in a cause-specific hazard function. RESULTS: Controlling for background factors associated with mortality, there was lower mortality for children with a BCG scar than without in cohort B, the mortality ratio (MR) being 0.45 (95% CI 0.21-0.96). Exclusion of children exposed to TB did not have any impact on the result. In a combined analysis of cohorts A and B, the MR was 0.43 (95% CI 0.28-0.65) controlling for background factors. There were no large differences in distribution of the five major causes of death (malaria, pneumonia, acute diarrhoea, chronic diarrhoea, and meningitis/encephalitis) according to BCG scar status in the two cohorts. Having a BCG scar significantly reduced the risk of death from malaria [MR 0.32 (95% CI 0.13-0.76)]. CONCLUSIONS: A BCG scar is a marker of better survival among children in countries with high child mortality. BCG vaccination may affect the response to several major infections including malaria.