Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh.
<h4>Background</h4>Bacillus Calmette-Guérin (BCG) vaccination has recently been found to have beneficial effects among children infected other than Mycobacterium tuberculosis. Due to the paucity of data on the outcomes of children who had successful BCG vaccination following Expanded Pro...
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Public Library of Science (PLoS)
2022-01-01
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| author | Mst Mahmuda Ackhter Abu Sadat Mohammad Sayeem Bin Shahid Tahmeed Ahmed Parag Palit Irin Parvin Md Zahidul Islam Tahmina Alam Shamsun Nahar Shaima Lubaba Shahrin Farzana Afroze Monira Sarmin Shoeb Bin Islam Zubair Akhtar Mohammod Jobayer Chisti Fahmida Chowdhury |
| author_facet | Mst Mahmuda Ackhter Abu Sadat Mohammad Sayeem Bin Shahid Tahmeed Ahmed Parag Palit Irin Parvin Md Zahidul Islam Tahmina Alam Shamsun Nahar Shaima Lubaba Shahrin Farzana Afroze Monira Sarmin Shoeb Bin Islam Zubair Akhtar Mohammod Jobayer Chisti Fahmida Chowdhury |
| author_sort | Mst Mahmuda Ackhter |
| collection | DOAJ |
| description | <h4>Background</h4>Bacillus Calmette-Guérin (BCG) vaccination has recently been found to have beneficial effects among children infected other than Mycobacterium tuberculosis. Due to the paucity of data on the outcomes of children who had successful BCG vaccination following Expanded Programme on Immunization (EPI) schedule, we aimed to investigate the characteristics of such children and their outcomes who were hospitalized for severe malnutrition.<h4>Methods</h4>A prospective observational study was conducted to determine the viral etiology of pneumonia in severely malnourished children those were admitted to the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) between April 2015 and December 2017, constituted the study population. Using a case-control design for the analysis, children having BCG vaccination prior hospital admission were treated as cases (n = 611) and those without vaccination, constituted as controls (n = 83). Bi-variate analysis was conducted using socio-demographic, clinical, laboratory, and treatment characteristics on admission and outcomes during hospitalization. Finally, log-linear binomial regression analysis was done to identify independent impact of BCG vaccination.<h4>Results</h4>The cases more often presented with older age, have had lower proportion of maternal illiteracy, higher rate of breastfeeding, severe wasting and lower rate of hypoglycemia, compared to the controls. The cases were also found to have lower risk of severe sepsis and deaths, compared to the controls (for all, p<0.05). However, in log-linear binomial regression analysis, after adjusting for potential confounders, BCG vaccination following EPI schedule (RR:0.54; 95%CI = 0.33-0.89; p = 0.015) and breastfeeding (RR:0.53; 95%CI = 0.35-0.81; p = 0.003) were found to be protective for the development of severe sepsis.<h4>Conclusion</h4>BCG vaccination and breastfeeding were found to be protective for the development of severe sepsis in hospitalized severely malnourished under-five children which underscores the importance of continuation of BCG vaccination at birth and breastfeeding up to two years of age. |
| format | Article |
| id | doaj-art-6fdf1766dd244c699cc5ede3df4615d9 |
| institution | OA Journals |
| issn | 1932-6203 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-6fdf1766dd244c699cc5ede3df4615d92025-08-20T02:02:12ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01171e026239110.1371/journal.pone.0262391Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh.Mst Mahmuda AckhterAbu Sadat Mohammad Sayeem Bin ShahidTahmeed AhmedParag PalitIrin ParvinMd Zahidul IslamTahmina AlamShamsun Nahar ShaimaLubaba ShahrinFarzana AfrozeMonira SarminShoeb Bin IslamZubair AkhtarMohammod Jobayer ChistiFahmida Chowdhury<h4>Background</h4>Bacillus Calmette-Guérin (BCG) vaccination has recently been found to have beneficial effects among children infected other than Mycobacterium tuberculosis. Due to the paucity of data on the outcomes of children who had successful BCG vaccination following Expanded Programme on Immunization (EPI) schedule, we aimed to investigate the characteristics of such children and their outcomes who were hospitalized for severe malnutrition.<h4>Methods</h4>A prospective observational study was conducted to determine the viral etiology of pneumonia in severely malnourished children those were admitted to the Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) between April 2015 and December 2017, constituted the study population. Using a case-control design for the analysis, children having BCG vaccination prior hospital admission were treated as cases (n = 611) and those without vaccination, constituted as controls (n = 83). Bi-variate analysis was conducted using socio-demographic, clinical, laboratory, and treatment characteristics on admission and outcomes during hospitalization. Finally, log-linear binomial regression analysis was done to identify independent impact of BCG vaccination.<h4>Results</h4>The cases more often presented with older age, have had lower proportion of maternal illiteracy, higher rate of breastfeeding, severe wasting and lower rate of hypoglycemia, compared to the controls. The cases were also found to have lower risk of severe sepsis and deaths, compared to the controls (for all, p<0.05). However, in log-linear binomial regression analysis, after adjusting for potential confounders, BCG vaccination following EPI schedule (RR:0.54; 95%CI = 0.33-0.89; p = 0.015) and breastfeeding (RR:0.53; 95%CI = 0.35-0.81; p = 0.003) were found to be protective for the development of severe sepsis.<h4>Conclusion</h4>BCG vaccination and breastfeeding were found to be protective for the development of severe sepsis in hospitalized severely malnourished under-five children which underscores the importance of continuation of BCG vaccination at birth and breastfeeding up to two years of age.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0262391&type=printable |
| spellingShingle | Mst Mahmuda Ackhter Abu Sadat Mohammad Sayeem Bin Shahid Tahmeed Ahmed Parag Palit Irin Parvin Md Zahidul Islam Tahmina Alam Shamsun Nahar Shaima Lubaba Shahrin Farzana Afroze Monira Sarmin Shoeb Bin Islam Zubair Akhtar Mohammod Jobayer Chisti Fahmida Chowdhury Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh. PLoS ONE |
| title | Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh. |
| title_full | Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh. |
| title_fullStr | Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh. |
| title_full_unstemmed | Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh. |
| title_short | Characteristics of severely malnourished under-five children immunized with Bacillus Calmette-Guérin following Expanded Programme on Immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre, Bangladesh. |
| title_sort | characteristics of severely malnourished under five children immunized with bacillus calmette guerin following expanded programme on immunization schedule and their outcomes during hospitalization at an urban diarrheal treatment centre bangladesh |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0262391&type=printable |
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