Effect of Bacillus Calmette-Guérin vaccination against Mycobacterium tuberculosis infection in children: an updated systematic review and meta-analysis
Objectives: To update the understanding of the effectiveness of the Bacillus Calmette-Guérin (BCG) vaccine in preventing tuberculosis (TB) infection in children. Methods: PubMed, Web of Science, Cochrane, and Embase were searched from their inception to January 12, 2025. Studies were included if the...
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| Format: | Article |
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Elsevier
2025-07-01
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| Series: | International Journal of Infectious Diseases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971225001328 |
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| author | Shunli Cai Qingyi Luo Guozhong Zhou Xin Guo Yan Dong Hongbo Chen Shiqi Luo Jian He Yuan Xia Hanse Li Yingchen Zhou Chao Song |
| author_facet | Shunli Cai Qingyi Luo Guozhong Zhou Xin Guo Yan Dong Hongbo Chen Shiqi Luo Jian He Yuan Xia Hanse Li Yingchen Zhou Chao Song |
| author_sort | Shunli Cai |
| collection | DOAJ |
| description | Objectives: To update the understanding of the effectiveness of the Bacillus Calmette-Guérin (BCG) vaccine in preventing tuberculosis (TB) infection in children. Methods: PubMed, Web of Science, Cochrane, and Embase were searched from their inception to January 12, 2025. Studies were included if they focused on children under 19 years exposed to pulmonary TB, used interferon-gamma release assays (IGRA) for infection assessment, and reported IGRA-positive outcomes for both BCG and non-BCG groups. Pooled estimates were derived using random-effects meta-analysis, with heterogeneity assessed by the I² statistic. Results: Total 8242 participants were enrolled in 32 studies. The overall protective effectiveness of BCG against infection was 18%, with a relative risk [RR] of 0.82 (95% confidence interval [CI]: 0.73-0.91], I² = 60%). Subgroup analysis revealed a higher effectiveness of 29% (RR = 0.71 [95% CI: 0.62-0.82], I² = 41%) in low-TB incidence areas, while effectiveness was not significant (RR = 0.95 [95% CI: 0.84-1.09], I² = 55%) in high-TB incidence areas. Conclusions: BCG vaccination shows protective effectiveness against TB infection, particularly in low-TB incidence areas. Its effectiveness in high-TB incidence areas remains uncertain, underscoring the need for further research to optimize vaccination strategies in these settings. |
| format | Article |
| id | doaj-art-7698d3688cd64a2f88d5b3ec439d7aa9 |
| institution | Kabale University |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Infectious Diseases |
| spelling | doaj-art-7698d3688cd64a2f88d5b3ec439d7aa92025-08-20T03:46:41ZengElsevierInternational Journal of Infectious Diseases1201-97122025-07-0115610790910.1016/j.ijid.2025.107909Effect of Bacillus Calmette-Guérin vaccination against Mycobacterium tuberculosis infection in children: an updated systematic review and meta-analysisShunli Cai0Qingyi Luo1Guozhong Zhou2Xin Guo3Yan Dong4Hongbo Chen5Shiqi Luo6Jian He7Yuan Xia8Hanse Li9Yingchen Zhou10Chao Song11Department of Pain Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China; Faculty of Life Science and Technology, The affiliated Anning First People's Hospital, Kunming University of Science and Technology, Kunming, Yunnan Province, ChinaDepartment of Medical Imaging, Yan’an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan Province, ChinaDepartment of Pain Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China; School of Basic Medical Sciences, Kunming University of Science and Technology, Kunming, Yunnan Province, ChinaFaculty of Life Science and Technology, The affiliated Anning First People's Hospital, Kunming University of Science and Technology, Kunming, Yunnan Province, ChinaDepartment of Pain Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China; School of Basic Medical Sciences, Kunming University of Science and Technology, Kunming, Yunnan Province, ChinaDepartment of Pulmonary and Critical Care Medicine, Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Kunming, Yunnan Province, ChinaDepartment of Immunology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, ChinaDepartment of Pulmonary and Critical Care Medicine, Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Kunming, Yunnan Province, ChinaSchool of Basic Medical Sciences, Kunming Medical University, Kunming, Yunnan Province, ChinaSchool of Basic Medical Sciences, Kunming Medical University, Kunming, Yunnan Province, ChinaThe School of Medicine, Kunming University, Kunming, Yunnan Province, ChinaDepartment of Pain Medicine, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Kunming, Yunnan Province, China; Department of Medical Imaging, Anning First People's Hospital Affiliated to Kunming University of Science and Technology, Kunming, Yunnan Province, China; Corresponding author: Chao Song, The Affiliated Anning First People's Hospital of Kunming University of Science and Technology, Ganghe South Road, Anning City, Kunming, Yunnan 650302, China.Objectives: To update the understanding of the effectiveness of the Bacillus Calmette-Guérin (BCG) vaccine in preventing tuberculosis (TB) infection in children. Methods: PubMed, Web of Science, Cochrane, and Embase were searched from their inception to January 12, 2025. Studies were included if they focused on children under 19 years exposed to pulmonary TB, used interferon-gamma release assays (IGRA) for infection assessment, and reported IGRA-positive outcomes for both BCG and non-BCG groups. Pooled estimates were derived using random-effects meta-analysis, with heterogeneity assessed by the I² statistic. Results: Total 8242 participants were enrolled in 32 studies. The overall protective effectiveness of BCG against infection was 18%, with a relative risk [RR] of 0.82 (95% confidence interval [CI]: 0.73-0.91], I² = 60%). Subgroup analysis revealed a higher effectiveness of 29% (RR = 0.71 [95% CI: 0.62-0.82], I² = 41%) in low-TB incidence areas, while effectiveness was not significant (RR = 0.95 [95% CI: 0.84-1.09], I² = 55%) in high-TB incidence areas. Conclusions: BCG vaccination shows protective effectiveness against TB infection, particularly in low-TB incidence areas. Its effectiveness in high-TB incidence areas remains uncertain, underscoring the need for further research to optimize vaccination strategies in these settings.http://www.sciencedirect.com/science/article/pii/S1201971225001328Bacillus Calmette-GuérinMycobacterium tuberculosis infectionChildrenInterferon-gamma release assaysMeta-analysis |
| spellingShingle | Shunli Cai Qingyi Luo Guozhong Zhou Xin Guo Yan Dong Hongbo Chen Shiqi Luo Jian He Yuan Xia Hanse Li Yingchen Zhou Chao Song Effect of Bacillus Calmette-Guérin vaccination against Mycobacterium tuberculosis infection in children: an updated systematic review and meta-analysis International Journal of Infectious Diseases Bacillus Calmette-Guérin Mycobacterium tuberculosis infection Children Interferon-gamma release assays Meta-analysis |
| title | Effect of Bacillus Calmette-Guérin vaccination against Mycobacterium tuberculosis infection in children: an updated systematic review and meta-analysis |
| title_full | Effect of Bacillus Calmette-Guérin vaccination against Mycobacterium tuberculosis infection in children: an updated systematic review and meta-analysis |
| title_fullStr | Effect of Bacillus Calmette-Guérin vaccination against Mycobacterium tuberculosis infection in children: an updated systematic review and meta-analysis |
| title_full_unstemmed | Effect of Bacillus Calmette-Guérin vaccination against Mycobacterium tuberculosis infection in children: an updated systematic review and meta-analysis |
| title_short | Effect of Bacillus Calmette-Guérin vaccination against Mycobacterium tuberculosis infection in children: an updated systematic review and meta-analysis |
| title_sort | effect of bacillus calmette guerin vaccination against mycobacterium tuberculosis infection in children an updated systematic review and meta analysis |
| topic | Bacillus Calmette-Guérin Mycobacterium tuberculosis infection Children Interferon-gamma release assays Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S1201971225001328 |
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