Disseminated bacille Calmette-Guérin disease in HIV-infected South African infants

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dc.contributor.authorHesseling A.C.
dc.contributor.authorJohnson L.F.
dc.contributor.authorJaspan H.
dc.contributor.authorCotton M.F.
dc.contributor.authorWhitelaw A.
dc.contributor.authorSchaaf H.S.
dc.contributor.authorFine P.E.M.
dc.contributor.authorEley B.S.
dc.contributor.authorMarais B.J.
dc.contributor.authorNuttall J.
dc.contributor.authorBeyers N.
dc.contributor.authorGodfrey-Faussett P.
dc.date.accessioned2011-05-15T16:15:50Z
dc.date.available2011-05-15T16:15:50Z
dc.date.issued2009
dc.description.abstractObjective: To determine the population-based incidence of disseminated bacille Calmette-Guérin (BCG) disease in HIV-infected infants (aged ≤ 1 year) in a setting with a high burden of tuberculosis and HIV infection coupled with a well-functioning programme for the prevention of HIV infection in infants. Methods: The numerator, or number of new cases of disseminated BCG disease, was derived from multicentre surveillance data collected prospectively on infants with a confirmed HIV infection during 2004-2006. The denominator, or total number of HIV-infected infants who were BCG-vaccinated, was derived from population-based estimates of the number of live infants and from reported maternal HIV infection prevalence, vertical HIV transmission rates and BCG vaccination rates. Findings: The estimated incidences of disseminated BCG disease per 100 000 BCG-vaccinated, HIV-infected infants were as follows: 778 (95% confidence interval, CI: 361-1319) in 2004 (vertical HIV transmission rate: 10.4%); 1300 (95% CI: 587-2290) in 2005 (transmission rate: 6.1%); and 1013 (95% CI: 377-1895) in 2006 (transmission rate: 5.4%). The pooled incidence over the study period was 992 (95% CI: 567-1495) per 100 000. Conclusion: Multicentre surveillance data showed that the risk of disseminated BCG disease in HIV-infected infants is considerably higher than previously estimated, although likely to be under-estimated. There is an urgent need for data on the risk-benefit ratio of BCG vaccination in HIV-infected infants to inform decision-making in settings where HIV infection and tuberculosis burdens are high. Safe and effective tuberculosis prevention strategies are needed for HIV-infected infants.
dc.description.versionArticle
dc.identifier.citationBulletin of the World Health Organization
dc.identifier.citation87
dc.identifier.citation7
dc.identifier.issn00429686
dc.identifier.other10.2471/BLT.08.055657
dc.identifier.urihttp://hdl.handle.net/10019.1/13511
dc.subjectBCG vaccine
dc.subjectchild health
dc.subjectconfidence interval
dc.subjectdecision making
dc.subjectdisease incidence
dc.subjectdisease prevalence
dc.subjectdisease transmission
dc.subjecthealth risk
dc.subjecthuman immunodeficiency virus
dc.subjectvaccination
dc.subjectarticle
dc.subjectBCG vaccination
dc.subjectclinical article
dc.subjecthealth program
dc.subjecthuman
dc.subjectHuman immunodeficiency virus infection
dc.subjectincidence
dc.subjectinfant
dc.subjectinfant disease
dc.subjectinfant mortality
dc.subjectinfection prevention
dc.subjectmiliary tuberculosis
dc.subjectSouth Africa
dc.subjectvertical transmission
dc.subjectvirus transmission
dc.subjectAnimals
dc.subjectBCG Vaccine
dc.subjectCattle
dc.subjectComorbidity
dc.subjectHIV Seropositivity
dc.subjectHumans
dc.subjectInfant
dc.subjectInfectious Disease Transmission, Vertical
dc.subjectMycobacterium bovis
dc.subjectPopulation Surveillance
dc.subjectProspective Studies
dc.subjectSouth Africa
dc.subjectTuberculosis, Bovine
dc.subjectAfrica
dc.subjectSouth Africa
dc.subjectSouthern Africa
dc.subjectSub-Saharan Africa
dc.titleDisseminated bacille Calmette-Guérin disease in HIV-infected South African infants
dc.typeArticle
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