Effectiveness of the Bacillus Calmette-Guerin vaccine in an Indonesian population with D543N NRAMP1 polymorphism

Introduction: Bacille Calmette-Guerin (BCG) vaccination remains a routine immunization in primary care in tuberculosis (TB)-endemic areas, though several studies found that its efficacy was inconclusive. Natural resistance-asociated machrophage protein 1 (NRAMP1) polymorphism has been shown to resul...

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Main Authors: Ikhwanuliman Putera, Trevino Aristarkus Pakasi, Ikrar Syahmar, Aulia Akbar Bramantyo, Elvina Karyadi, Ani Melani, Edhyana Sahiratmadja
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2015-01-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/5047
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author Ikhwanuliman Putera
Trevino Aristarkus Pakasi
Ikrar Syahmar
Aulia Akbar Bramantyo
Elvina Karyadi
Ani Melani
Edhyana Sahiratmadja
author_facet Ikhwanuliman Putera
Trevino Aristarkus Pakasi
Ikrar Syahmar
Aulia Akbar Bramantyo
Elvina Karyadi
Ani Melani
Edhyana Sahiratmadja
author_sort Ikhwanuliman Putera
collection DOAJ
description Introduction: Bacille Calmette-Guerin (BCG) vaccination remains a routine immunization in primary care in tuberculosis (TB)-endemic areas, though several studies found that its efficacy was inconclusive. Natural resistance-asociated machrophage protein 1 (NRAMP1) polymorphism has been shown to result in higher susceptibility to TB. Information on genetic susceptibility in populations will be useful in planning the application of the BCG vaccine. The present study explored BCG efficacy in a rural Timor population with specific NRAMP1 polymorphism in a TB-endemic region of eastern Indonesia. Methodology: A case-control study with 64 newly diagnosed pulmonary TB patients and 65 healthy controls was performed. BCG scars were examined by a physician. NRAMP1 polymorphism was evaluated using molecular methods. Results: Half of the subjects (65; 50.4%) had a clear presenting BCG scar on the upper arm, suggesting a successful BCG vaccination. Among the subjects, D543N NRAMP1 polymorphism, history of contact with TB patients, and not having a clear BCG scar on the upper arm tended to be significantly association with active TB. The significant differences were more profound when subjects were divided based on presenting BCG scar. Subjects without clear BCG scars had significant association with developing TB disease (p = 0.014). In multivariate analysis, history of previous contact with TB patients and unclear presenting BCG scar were associated with active TB (OR 9.2; 2.0–43.8 95% CI, OR 4.8; 2.1–11.0 95% CI, respectively). Conclusions: BCG vaccination in our population was effective for TB protection, especially in highly endemic areas of TB, regardless genetic susceptibility.
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spelling doaj-art-bc843258333b48bca05643696d9f6bc42025-08-20T02:57:45ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802015-01-0190110.3855/jidc.5047Effectiveness of the Bacillus Calmette-Guerin vaccine in an Indonesian population with D543N NRAMP1 polymorphismIkhwanuliman Putera0Trevino Aristarkus Pakasi1Ikrar Syahmar2Aulia Akbar Bramantyo3Elvina Karyadi4Ani Melani5Edhyana Sahiratmadja6Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaFaculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaFaculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaFaculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaSouth East Asia Minister of Education Organization Tropical Medicine, Universitas Indonesia Jakarta, IndonesiaFaculty of Medicine Universitas Padjajaran, Bandung, IndonesiaFaculty of Medicine Universitas Padjajaran, Bandung, IndonesiaIntroduction: Bacille Calmette-Guerin (BCG) vaccination remains a routine immunization in primary care in tuberculosis (TB)-endemic areas, though several studies found that its efficacy was inconclusive. Natural resistance-asociated machrophage protein 1 (NRAMP1) polymorphism has been shown to result in higher susceptibility to TB. Information on genetic susceptibility in populations will be useful in planning the application of the BCG vaccine. The present study explored BCG efficacy in a rural Timor population with specific NRAMP1 polymorphism in a TB-endemic region of eastern Indonesia. Methodology: A case-control study with 64 newly diagnosed pulmonary TB patients and 65 healthy controls was performed. BCG scars were examined by a physician. NRAMP1 polymorphism was evaluated using molecular methods. Results: Half of the subjects (65; 50.4%) had a clear presenting BCG scar on the upper arm, suggesting a successful BCG vaccination. Among the subjects, D543N NRAMP1 polymorphism, history of contact with TB patients, and not having a clear BCG scar on the upper arm tended to be significantly association with active TB. The significant differences were more profound when subjects were divided based on presenting BCG scar. Subjects without clear BCG scars had significant association with developing TB disease (p = 0.014). In multivariate analysis, history of previous contact with TB patients and unclear presenting BCG scar were associated with active TB (OR 9.2; 2.0–43.8 95% CI, OR 4.8; 2.1–11.0 95% CI, respectively). Conclusions: BCG vaccination in our population was effective for TB protection, especially in highly endemic areas of TB, regardless genetic susceptibility. https://jidc.org/index.php/journal/article/view/5047BCG vaccinationtuberculosisNRAMP1 polymorphism
spellingShingle Ikhwanuliman Putera
Trevino Aristarkus Pakasi
Ikrar Syahmar
Aulia Akbar Bramantyo
Elvina Karyadi
Ani Melani
Edhyana Sahiratmadja
Effectiveness of the Bacillus Calmette-Guerin vaccine in an Indonesian population with D543N NRAMP1 polymorphism
Journal of Infection in Developing Countries
BCG vaccination
tuberculosis
NRAMP1 polymorphism
title Effectiveness of the Bacillus Calmette-Guerin vaccine in an Indonesian population with D543N NRAMP1 polymorphism
title_full Effectiveness of the Bacillus Calmette-Guerin vaccine in an Indonesian population with D543N NRAMP1 polymorphism
title_fullStr Effectiveness of the Bacillus Calmette-Guerin vaccine in an Indonesian population with D543N NRAMP1 polymorphism
title_full_unstemmed Effectiveness of the Bacillus Calmette-Guerin vaccine in an Indonesian population with D543N NRAMP1 polymorphism
title_short Effectiveness of the Bacillus Calmette-Guerin vaccine in an Indonesian population with D543N NRAMP1 polymorphism
title_sort effectiveness of the bacillus calmette guerin vaccine in an indonesian population with d543n nramp1 polymorphism
topic BCG vaccination
tuberculosis
NRAMP1 polymorphism
url https://jidc.org/index.php/journal/article/view/5047
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