Epidemiology of childhood tuberculosis after ceasing universal Bacillus Calmette–Guérin vaccination

Abstract Universal Bacillus Calmette–Guérin (BCG) vaccination is recommended in countries with high tuberculosis (TB) burden. Nevertheless, several countries have ceased universal BCG vaccination over the past 40 years, with scarce comparative epidemiological analyses regarding childhood TB after th...

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Autores principales:	Sayori Kobayashi, Takashi Yoshiyama, Kazuhiro Uchimura, Yuko Hamaguchi, Seiya Kato
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/03cc6bdeb0f1483fbfefd6f08ccfaf5e
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spelling	oai:doaj.org-article:03cc6bdeb0f1483fbfefd6f08ccfaf5e2021-12-02T17:06:10ZEpidemiology of childhood tuberculosis after ceasing universal Bacillus Calmette–Guérin vaccination10.1038/s41598-021-95294-y2045-2322https://doaj.org/article/03cc6bdeb0f1483fbfefd6f08ccfaf5e2021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95294-yhttps://doaj.org/toc/2045-2322Abstract Universal Bacillus Calmette–Guérin (BCG) vaccination is recommended in countries with high tuberculosis (TB) burden. Nevertheless, several countries have ceased universal BCG vaccination over the past 40 years, with scarce comparative epidemiological analyses regarding childhood TB after the policy change. We analysed data on childhood TB in countries that ceased universal BCG vaccination. Data sources included national/international databases, published papers, annual TB reports, and public health authority websites. Childhood TB notification rate increased in one of seven countries with available data. Pulmonary TB and TB lymphadenitis were the main causes of increasing childhood cases, while changes in severe forms of TB cases were minor. Maintaining high vaccine coverage for the target group was a common challenge after shifting selective vaccination. In some countries showing no increase in childhood TB after a BCG policy change, the majority of childhood TB cases were patients from abroad or those with overseas parents; these countries had changed immigration policies during the same period. Heterogeneity in childhood TB epidemiology was observed after ceasing universal BCG vaccination; several factors might obscure the influence of vaccination policy change. Lessons learned from these countries may aid in the development of better BCG vaccination strategies.Sayori KobayashiTakashi YoshiyamaKazuhiro UchimuraYuko HamaguchiSeiya KatoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sayori Kobayashi Takashi Yoshiyama Kazuhiro Uchimura Yuko Hamaguchi Seiya Kato Epidemiology of childhood tuberculosis after ceasing universal Bacillus Calmette–Guérin vaccination
description	Abstract Universal Bacillus Calmette–Guérin (BCG) vaccination is recommended in countries with high tuberculosis (TB) burden. Nevertheless, several countries have ceased universal BCG vaccination over the past 40 years, with scarce comparative epidemiological analyses regarding childhood TB after the policy change. We analysed data on childhood TB in countries that ceased universal BCG vaccination. Data sources included national/international databases, published papers, annual TB reports, and public health authority websites. Childhood TB notification rate increased in one of seven countries with available data. Pulmonary TB and TB lymphadenitis were the main causes of increasing childhood cases, while changes in severe forms of TB cases were minor. Maintaining high vaccine coverage for the target group was a common challenge after shifting selective vaccination. In some countries showing no increase in childhood TB after a BCG policy change, the majority of childhood TB cases were patients from abroad or those with overseas parents; these countries had changed immigration policies during the same period. Heterogeneity in childhood TB epidemiology was observed after ceasing universal BCG vaccination; several factors might obscure the influence of vaccination policy change. Lessons learned from these countries may aid in the development of better BCG vaccination strategies.
format	article
author	Sayori Kobayashi Takashi Yoshiyama Kazuhiro Uchimura Yuko Hamaguchi Seiya Kato
author_facet	Sayori Kobayashi Takashi Yoshiyama Kazuhiro Uchimura Yuko Hamaguchi Seiya Kato
author_sort	Sayori Kobayashi
title	Epidemiology of childhood tuberculosis after ceasing universal Bacillus Calmette–Guérin vaccination
title_short	Epidemiology of childhood tuberculosis after ceasing universal Bacillus Calmette–Guérin vaccination
title_full	Epidemiology of childhood tuberculosis after ceasing universal Bacillus Calmette–Guérin vaccination
title_fullStr	Epidemiology of childhood tuberculosis after ceasing universal Bacillus Calmette–Guérin vaccination
title_full_unstemmed	Epidemiology of childhood tuberculosis after ceasing universal Bacillus Calmette–Guérin vaccination
title_sort	epidemiology of childhood tuberculosis after ceasing universal bacillus calmette–guérin vaccination
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/03cc6bdeb0f1483fbfefd6f08ccfaf5e
work_keys_str_mv	AT sayorikobayashi epidemiologyofchildhoodtuberculosisafterceasinguniversalbacilluscalmetteguerinvaccination AT takashiyoshiyama epidemiologyofchildhoodtuberculosisafterceasinguniversalbacilluscalmetteguerinvaccination AT kazuhirouchimura epidemiologyofchildhoodtuberculosisafterceasinguniversalbacilluscalmetteguerinvaccination AT yukohamaguchi epidemiologyofchildhoodtuberculosisafterceasinguniversalbacilluscalmetteguerinvaccination AT seiyakato epidemiologyofchildhoodtuberculosisafterceasinguniversalbacilluscalmetteguerinvaccination
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Epidemiology of childhood tuberculosis after ceasing universal Bacillus Calmette–Guérin vaccination

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