TY - JOUR
T1 - BCG vaccination status may predict sputum conversion in patients with pulmonary tuberculosis
T2 - a new consideration for an old vaccine?
AU - Jeremiah, Kidola
AU - PrayGod, George
AU - Faurholt-Jepsen, Daniel
AU - Range, Nyagosya
AU - Andersen, Aase B.
AU - Grewal, Harleen M.S.
AU - Friis, Henrik
PY - 2010/12
Y1 - 2010/12
N2 - Background: Failure to convert (persistent sputum and/or culture positivity) while on antituberculosis (anti-TB) treatment at the end of the second month of anti-TB therapy has been reported to be a predictor of treatment failure. Factors that could be associated with persistent bacillary positivity at the end of the second month after initiation of anti-TB treatment were assessed. Methods: A prospective cohort study was conducted in 754 patients with sputum culture positive pulmonary TB in Mwanza, Tanzania. Information on social demographic characteristics, anthropometric measurements, BCG scar status, HIV status, CD4+ count, white blood cell count, haemoglobin and sputum culture status was obtained. Results: Factors associated with sputum culture non-conversion at the end of the second month of anti-TB treatment were initial acid-fast bacilli (AFB) culture grading of 3+ (OR 5.70, 95% CI 1.34 to 24.31, p=0.02) and absence of a BCG scar (OR 3.35, 95% CI 1.48 to 7.58, p=0.004). Conclusion: Patients with pulmonary TB with no BCG scar and high initial AFB sputum intensity are at risk of remaining sputum culture positive at the end of the second month of anti-TB treatment. These findings reflect a beneficial role for BCG vaccination on sputum conversion which should also be examined in large studies in other areas. The finding of a beneficial role for BCG vaccination on the treatment of pulmonary TB is important for TB control and vaccination programmes.
AB - Background: Failure to convert (persistent sputum and/or culture positivity) while on antituberculosis (anti-TB) treatment at the end of the second month of anti-TB therapy has been reported to be a predictor of treatment failure. Factors that could be associated with persistent bacillary positivity at the end of the second month after initiation of anti-TB treatment were assessed. Methods: A prospective cohort study was conducted in 754 patients with sputum culture positive pulmonary TB in Mwanza, Tanzania. Information on social demographic characteristics, anthropometric measurements, BCG scar status, HIV status, CD4+ count, white blood cell count, haemoglobin and sputum culture status was obtained. Results: Factors associated with sputum culture non-conversion at the end of the second month of anti-TB treatment were initial acid-fast bacilli (AFB) culture grading of 3+ (OR 5.70, 95% CI 1.34 to 24.31, p=0.02) and absence of a BCG scar (OR 3.35, 95% CI 1.48 to 7.58, p=0.004). Conclusion: Patients with pulmonary TB with no BCG scar and high initial AFB sputum intensity are at risk of remaining sputum culture positive at the end of the second month of anti-TB treatment. These findings reflect a beneficial role for BCG vaccination on sputum conversion which should also be examined in large studies in other areas. The finding of a beneficial role for BCG vaccination on the treatment of pulmonary TB is important for TB control and vaccination programmes.
U2 - 10.1136/thx.2010.134767
DO - 10.1136/thx.2010.134767
M3 - Journal article
C2 - 20889521
SN - 0040-6376
VL - 65
SP - 1072
EP - 1076
JO - Thorax
JF - Thorax
IS - 12
ER -
