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Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo
BACKGROUND: The only available vaccine that could be potentially beneficial against mycobacterial diseases contains live attenuated bovine tuberculosis bacillus (Mycobacterium bovis) also called Bacillus Calmette-Guérin (BCG). Even though the BCG vaccine is still widely used, results on its effectiv...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287572/ https://www.ncbi.nlm.nih.gov/pubmed/25569674 http://dx.doi.org/10.1371/journal.pntd.0003457 |
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author | Phillips, Richard Odame Phanzu, Delphin Mavinga Beissner, Marcus Badziklou, Kossi Luzolo, Elysée Kalundieko Sarfo, Fred Stephen Halatoko, Wemboo Afiwa Amoako, Yaw Frimpong, Michael Kabiru, Abass Mohammed Piten, Ebekalisai Maman, Issaka Bidjada, Bawimodom Koba, Adjaho Awoussi, Koffi Somenou Kobara, Basile Nitschke, Jörg Wiedemann, Franz Xaver Kere, Abiba Banla Adjei, Ohene Löscher, Thomas Fleischer, Bernhard Bretzel, Gisela Herbinger, Karl-Heinz |
author_facet | Phillips, Richard Odame Phanzu, Delphin Mavinga Beissner, Marcus Badziklou, Kossi Luzolo, Elysée Kalundieko Sarfo, Fred Stephen Halatoko, Wemboo Afiwa Amoako, Yaw Frimpong, Michael Kabiru, Abass Mohammed Piten, Ebekalisai Maman, Issaka Bidjada, Bawimodom Koba, Adjaho Awoussi, Koffi Somenou Kobara, Basile Nitschke, Jörg Wiedemann, Franz Xaver Kere, Abiba Banla Adjei, Ohene Löscher, Thomas Fleischer, Bernhard Bretzel, Gisela Herbinger, Karl-Heinz |
author_sort | Phillips, Richard Odame |
collection | PubMed |
description | BACKGROUND: The only available vaccine that could be potentially beneficial against mycobacterial diseases contains live attenuated bovine tuberculosis bacillus (Mycobacterium bovis) also called Bacillus Calmette-Guérin (BCG). Even though the BCG vaccine is still widely used, results on its effectiveness in preventing mycobacterial diseases are partially contradictory, especially regarding Buruli Ulcer Disease (BUD). The aim of this case-control study is to evaluate the possible protective effect of BCG vaccination on BUD. METHODOLOGY: The present study was performed in three different countries and sites where BUD is endemic: in the Democratic Republic of the Congo, Ghana, and Togo from 2010 through 2013. The large study population was comprised of 401 cases with laboratory confirmed BUD and 826 controls, mostly family members or neighbors. PRINCIPAL FINDINGS: After stratification by the three countries, two sexes and four age groups, no significant correlation was found between the presence of BCG scar and BUD status of individuals. Multivariate analysis has shown that the independent variables country (p = 0.31), sex (p = 0.24), age (p = 0.96), and presence of a BCG scar (p = 0.07) did not significantly influence the development of BUD category I or category II/III. Furthermore, the status of BCG vaccination was also not significantly related to duration of BUD or time to healing of lesions. CONCLUSIONS: In our study, we did not observe significant evidence of a protective effect of routine BCG vaccination on the risk of developing either BUD or severe forms of BUD. Since accurate data on BCG strains used in these three countries were not available, no final conclusion can be drawn on the effectiveness of BCG strain in protecting against BUD. As has been suggested for tuberculosis and leprosy, well-designed prospective studies on different existing BCG vaccine strains are needed also for BUD. |
format | Online Article Text |
id | pubmed-4287572 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-42875722015-01-12 Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo Phillips, Richard Odame Phanzu, Delphin Mavinga Beissner, Marcus Badziklou, Kossi Luzolo, Elysée Kalundieko Sarfo, Fred Stephen Halatoko, Wemboo Afiwa Amoako, Yaw Frimpong, Michael Kabiru, Abass Mohammed Piten, Ebekalisai Maman, Issaka Bidjada, Bawimodom Koba, Adjaho Awoussi, Koffi Somenou Kobara, Basile Nitschke, Jörg Wiedemann, Franz Xaver Kere, Abiba Banla Adjei, Ohene Löscher, Thomas Fleischer, Bernhard Bretzel, Gisela Herbinger, Karl-Heinz PLoS Negl Trop Dis Research Article BACKGROUND: The only available vaccine that could be potentially beneficial against mycobacterial diseases contains live attenuated bovine tuberculosis bacillus (Mycobacterium bovis) also called Bacillus Calmette-Guérin (BCG). Even though the BCG vaccine is still widely used, results on its effectiveness in preventing mycobacterial diseases are partially contradictory, especially regarding Buruli Ulcer Disease (BUD). The aim of this case-control study is to evaluate the possible protective effect of BCG vaccination on BUD. METHODOLOGY: The present study was performed in three different countries and sites where BUD is endemic: in the Democratic Republic of the Congo, Ghana, and Togo from 2010 through 2013. The large study population was comprised of 401 cases with laboratory confirmed BUD and 826 controls, mostly family members or neighbors. PRINCIPAL FINDINGS: After stratification by the three countries, two sexes and four age groups, no significant correlation was found between the presence of BCG scar and BUD status of individuals. Multivariate analysis has shown that the independent variables country (p = 0.31), sex (p = 0.24), age (p = 0.96), and presence of a BCG scar (p = 0.07) did not significantly influence the development of BUD category I or category II/III. Furthermore, the status of BCG vaccination was also not significantly related to duration of BUD or time to healing of lesions. CONCLUSIONS: In our study, we did not observe significant evidence of a protective effect of routine BCG vaccination on the risk of developing either BUD or severe forms of BUD. Since accurate data on BCG strains used in these three countries were not available, no final conclusion can be drawn on the effectiveness of BCG strain in protecting against BUD. As has been suggested for tuberculosis and leprosy, well-designed prospective studies on different existing BCG vaccine strains are needed also for BUD. Public Library of Science 2015-01-08 /pmc/articles/PMC4287572/ /pubmed/25569674 http://dx.doi.org/10.1371/journal.pntd.0003457 Text en © 2015 Phillips et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Phillips, Richard Odame Phanzu, Delphin Mavinga Beissner, Marcus Badziklou, Kossi Luzolo, Elysée Kalundieko Sarfo, Fred Stephen Halatoko, Wemboo Afiwa Amoako, Yaw Frimpong, Michael Kabiru, Abass Mohammed Piten, Ebekalisai Maman, Issaka Bidjada, Bawimodom Koba, Adjaho Awoussi, Koffi Somenou Kobara, Basile Nitschke, Jörg Wiedemann, Franz Xaver Kere, Abiba Banla Adjei, Ohene Löscher, Thomas Fleischer, Bernhard Bretzel, Gisela Herbinger, Karl-Heinz Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo |
title | Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo |
title_full | Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo |
title_fullStr | Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo |
title_full_unstemmed | Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo |
title_short | Effectiveness of Routine BCG Vaccination on Buruli Ulcer Disease: A Case-Control Study in the Democratic Republic of Congo, Ghana and Togo |
title_sort | effectiveness of routine bcg vaccination on buruli ulcer disease: a case-control study in the democratic republic of congo, ghana and togo |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287572/ https://www.ncbi.nlm.nih.gov/pubmed/25569674 http://dx.doi.org/10.1371/journal.pntd.0003457 |
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