ArticleCanadian journal of public health = Revue canadienne de sante publique
Pediatric tuberculosis in Alberta First Nations (1991-2000): outbreaks and the protective effect of bacille Calmette-Guérin (BCG) vaccine.
Article in Canadian journal of public health = Revue canadienne de sante publique. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Tuberculosis among northern Manitoba First Nations, 2008-2012: program performance on- and off-reserve.Canadian journal of public health = Revue canadienne de sante publique · 2019Article
- Epidemiological and genomic determinants of tuberculosis outbreaks in First Nations communities in Canada.BMC medicine · 2018Article
- Towards the elimination of paediatric tuberculosis in high-income, immigrant-receiving countries: a 25-year conventional and molecular epidemiological case study.ERJ open research · 2018Article
- Do "Virtual" and "Outpatient" Public Health Tuberculosis Clinics Perform Equally Well? A Program-Wide Evaluation in Alberta, Canada.PloS one · 2015Article
- The benefits and risks of bacille Calmette-Guérin vaccination among infants at high risk for both tuberculosis and severe combined immunodeficiency: assessment by Markov model.BMC pediatrics · 2006Article
- Sustained intra- and inter-jurisdictional transmission of tuberculosis within a mobile, multi-ethnic social network: lessons for tuberculosis elimination.Canadian journal of public health = Revue canadienne de sante publiqueArticle
- Pediatric tuberculosis in Alberta: epidemiology and case characteristics (1990-2004).Canadian journal of public health = Revue canadienne de sante publiqueArticle
- Mycobacterium tuberculosis infection in First Nations preschool children in Alberta: implications for BCG (bacille Calmette-Guérin) vaccine withdrawal.Canadian journal of public health = Revue canadienne de sante publiqueArticle
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe tuberculosis control strategy of vaccinating First Nations newborns with BCG (bacille Calmette-Guerin) is currently undergoing re-evaluation in Canada. Review of recent pediatric tuberculosis morbidity could inform this re-evaluation.
methodsPotential source cases and pediatric cases of tuberculosis from Alberta First Nations were identified over the 10 years 1991-2000. The distribution of pediatric disease was described. The effect of BCG on tuberculosis morbidity in two large outbreaks was determined.
resultsA total of 57 potential source cases and 41 pediatric cases of tuberculosis were reported from 17 (41.5%) and 8 (19.5%) of the 41 on-reserve First Nation Community Health Centres, respectively. Three outbreaks traceable to three source cases accounted for 34 (18, 3, and 13, respectively) of the 41 (82.9%) pediatric cases. Each outbreak was spatially and temporally separate from the other. Each outbreak strain of Mycobacterium tuberculosis had a unique DNA fingerprint. In the largest outbreaks, disease-to-infection ratios (secondary case rates) were higher in newly infected unvaccinated versus vaccinated close pediatric contacts (12/13 [92.3%] versus 7/15 [46.7%], p=0.02), but the infection rate was almost certainly falsely high in the BCG vaccinated. One unvaccinated child had a brain tuberculoma in addition to primary pulmonary tuberculosis.
conclusionFor most Alberta First Nations communities, the spatial and temporal distribution of disease, and the meager impact on morbidity, challenge the rationale for continued use of BCG.
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15362464PMC6976086W1533077476What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.