International Journal of Epidemiology, Vol 26, 888-896, Copyright © 1997 by International Epidemiological Association
J Bertolli, C Pangi, R Frerichs and ME Halloran
BACKGROUND: Five randomized trials, a follow-up study, and six case-
control investigations of BCG vaccine's effectiveness (VE) for preventing
leprosy have been conducted internationally, with widely varying estimates
of VE. Because of the difficulty of generalizing from disparate results,
local estimates of VE are needed for health planning purposes and are
currently particularly relevant, given the World Health Organization's
(WHO) goal to eliminate leprosy by the year 2000. METHODS: We conducted a
case-control study in Yangon, Myanmar. Residents of Yangon between the ages
of 6 years and 24 years who were listed in the National Leprosy Registry as
being on active treatment for leprosy between December 1992 and April 1993
were eligible to participate in the study as cases. Control subjects were
matched to the cases on age, sex, and neighbourhood. RESULTS: One or more
doses of BCG were associated with a VE of 66%. The results show a
significant trend of increasing VE with increasing number of BCG doses (one
dose, VE = 55%; two doses, VE = 68%; three doses, VE = 87%). One dose of
BCG vaccine appeared to provide protection substantially higher than that
found in an earlier vaccine trial in Myanmar, but consistent with results
from case-control studies in other countries. CONCLUSIONS: These data
suggest that BCG reduces the risk of leprosy in Myanmar, and that BCG
vaccination of infants, along with early case-finding and treatment, should
be considered an important part of the leprosy intervention strategy.
ARTICLES
A case-control study of the effectiveness of BCG vaccine for preventing leprosy in Yangon, Myanmar
Epidemiology Program Office, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
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