Evaluation Of Bcg Vaccination In Infants And Pre School Children In Kalyobia:

Ezzat Abd El Moneam Mohamed

Despite modem advances in diagnositic techniques and effectivenessof treatments, Mycobacterium tuberculosis remains one of the pathogenscausing the greatest amount of chronic diseases and death throughout theworld.Also advances in the diagnosis and treatment of tuberculosis inchildren have lagged behind those in adults owing to diminished familiaritywith the disease and difficulty in performing clinical studies in children(Starke 1988).BCG is the method which can provide without any difficultiesreliable protection against tuberculous infection through creation of a longlasting immunity in the vaccinated individual.BCG vaccination has an appreciable effect in preventing childhoodtuberculosis. BCG vaccination soon after birth may not only protectagainst the acute manifestations of childhood tuberculosis but also, in thelong run, contribute significantly to the elimination of tuberculosis.By this study we aim to evaluate the efficiency ofBCG vaccine and thisstudy was carried out in rural areas ofkalyobia Govemerate on 500 Infantsand preschool children with age from 3 months to 5 years.All of them were chosen to be J3CG vaccinated, not suffering,convalescening from any disease or taking any drug that could affect thedegree of tuberculin test reaction.Tuberculin testing was carried out using PPD of 2U by Mantouxtechnique. The test was read after 48-72 hours and indurations of 5 mm ormore were considered positive.subjects with +ve tuberculin were examined by posteroanterior chestX-ray.- 314 individuls who were negative to PPD 2U were further re-evaluted byPPD lOU.The obtained results showed that.The collective percentage of tuberculin positivity in the first 5 yearsof life using PPD 2U was 37.25 and increased to 70.6% after re-evaluationbyPPD lOU.Also the positivity of tuberculin significantly decreases as ageincreases with no significante diffemce due to sex.There is direct relation between the size of BCG scar and thepositivity of tuberculin but with no relation between the age and the size ofBCGscar.The results of chest X-rays examination showed no abnormalitysuggestive of M. tuberculosis affection. This confirm the preventive valueof the BCG vaccination.from the previous results we can conclude that the allergy obtainedby vaccination with the Egyptian vaccine is satisfactory, keeping in mindthat those children received the vaccine in different rural welfare centersroutinely without taking strict precautions against light and heat.Follow up of vaccinated children by yearly tuberculin testing (10U) isadvisable to determine the efficacy of the vaccine, the duration of immunityand the optimal time for revaccihation.Tuberculin testing should be performed 3 days before vaccination,repeated 3 months after vaccination, then repeated yearly. This should beperformed by Mantoux testing using 10 UofPPD