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Rapid Protective Effects of Early BCG on Neonatal Mortality Among Low Birth Weight Boys: Observations From Randomized Trials.
Biering-Sørensen, Sofie; Jensen, Kristoffer Jarlov; Monterio, Ivan; Ravn, Henrik; Aaby, Peter; Benn, Christine Stabell.
Afiliação
  • Biering-Sørensen S; Projécto de Saúde Bandim, INDEPTH Network, Guinea-Bissau.
  • Jensen KJ; Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Copenhagen.
  • Monterio I; Projécto de Saúde Bandim, INDEPTH Network, Guinea-Bissau.
  • Ravn H; Research Center for Vitamins and Vaccines, Bandim Health Project, Statens Serum Institut, Copenhagen.
  • Aaby P; Section for Immunology and Vaccinology, National Veterinary Institute, Technical University of Denmark.
  • Benn CS; Projécto de Saúde Bandim, INDEPTH Network, Guinea-Bissau.
J Infect Dis ; 217(5): 759-766, 2018 02 14.
Article em En | MEDLINE | ID: mdl-29216358
Background: Three randomized trials (RCTs) in low-weight (<2.5 kg) infants have shown that Bacille Calmette-Guérin (BCG) vaccine nonspecifically reduces all-cause mortality in the neonatal period. Methods: Using data from 3 RCTs of early BCG (n = 6583) we examined potential sex differences in the timing of the mortality reduction in the neonatal period, presenting metaestimates of the main outcome mortality rate ratios (MRR) for BCG-vaccinated and controls. Results: Among controls, boys had a particularly high mortality during the first week after randomization: male-female MRR 2.71 (95% CI, 1.70-4.50). During the first week, BCG had a marked beneficial effect for boys, reducing mortality 3-fold (MRR [BCG/no BCG] = 0.36 [0.20-0.67]). In weeks 2-4 the effect waned for boys (MRR = 0.91 [0.51-1.69]). In girls, the pattern was opposite with a limited effect in the first week (MRR = 0.85 [0.46-1.54]), but a significant reduction in weeks 2-4 (MRR = 0.56 [0.31-1.00]). This was consistent in all 3 trials. Verbal autopsies linked early benefit to fewer sepsis-related deaths among BCG-vaccinated boys. Discussion: The marked reduction in mortality in the days after BCG vaccination in boys emphasizes the importance of providing BCG soon after birth. Trial registration numbers: ClinicalTrials.gov (NCT00146302) and ClinicalTrials.gov (NCT00625482).
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Recém-Nascido de Baixo Peso / Vacina BCG / Mortalidade Infantil Tipo de estudo: Clinical_trials Limite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Infect Dis Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Guiné-Bissau

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Recém-Nascido de Baixo Peso / Vacina BCG / Mortalidade Infantil Tipo de estudo: Clinical_trials Limite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Infect Dis Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Guiné-Bissau