The influence of neonatal BCG vaccination on in vitro cytokine responses to Plasmodium falciparum.

BACKGROUND: Bacillus Calmette-Guérin (BCG) vaccination has off-target protective effects against infections unrelated to tuberculosis. Among these, murine and human studies suggest that BCG vaccination may protect against malaria. We investigated whether BCG vaccination influences neonatal in vitro cytokine responses to Plasmodium falciparum. Blood samples were collected from 108 participants in the Melbourne Infant Study BCG for Allergy and Infection Reduction (MIS BAIR) randomised controlled trial (Clinical trials registration NCT01906853, registered July 2013), seven days after randomisation to neonatal BCG (n = 66) or no BCG vaccination (BCG-naïve, n = 42). In vitro cytokine responses were measured following stimulation with P. falciparum-infected erythrocytes (PfIE) or E. coli. RESULTS: No difference in the measured cytokines were observed between BCG-vaccinated and BCG-naïve neonates following stimulation with PfIE or E. coli. However, age at which blood was sampled was independently associated with altered cytokine responses to PfIE. Being male was also independently associated with increased TNF-a responses to both PfIE and E. coli. CONCLUSION: These findings do not support a role for BCG vaccination in influencing in vitro neonatal cytokine responses to P. falciparum. Older neonates are more likely to develop P. falciparum-induced IFN-γ and IFN-γ-inducible chemokine responses implicated in early protection against malaria and malaria pathogenesis.

South Thames Nuclear Medicine Survey 1996-97. South Thames Regional Nuclear Medicine Specialty Service Committee.

Data on the equipment available, staffing levels, number and type of procedures carried out in the South Thames Region during 1993-94 and 1996-97 are presented. These are compared with national data for 1993. The number of gamma cameras has increased by 5%, overall staffing by 15% and the number of procedures has increased by 31%. There has been a disproportionate increase in the technically more complex procedures, for example cardiac tomography (84%). Regional data have been collated since 1979 and techniques have been established to ensure consistency. Staffing levels, although improving, do not meet the minimum levels recommended by professional bodies. This raises questions about the quality and, possibly, the legality of the service provision.