Small percentage of children given BCG tuberculosis vaccine in India

WASHINGTON — Less than half the patients in a small study conducted in India had received bacille Calmette-Guérin tuberculosis vaccine, according to data presented at the 2016 American Academy of Dermatology annual meeting.

“Cutaneous tuberculosis is still highly prevalent in India and continues to be an important cause of morbidity in children,” Sumit Sethi, MD, in the department of dermatology at Maulana Azad Medical College in New Delhi, India, and colleagues wrote.

Sumit Sethi

To analyze the clinical pattern of cutaneous tuberculosis in children, the researchers conducted a prospective observational study of 20 patients at an outpatient dermatology department during a 1-year span. Patients were examined using serology for HIV, Mantoux tests, chest X-rays, cytology and histopathology. All were treated with a short-course regimen of anti-tubercular therapy.

Eights were diagnosed with lupus vulgaris, seven had scrofuloderma, five had lichen scrofulosorum, three had tubercular gumma and one patient had tuberculosis verrucosa cutis. Four patients were concomitantly infected by more than one type of skin tuberculosis. In addition, seven patients had regional lymph nodes, three had lung involvement, and one had involvement of the gastrointestinal tract and bone.

The researchers said that seven patients had a family history of tuberculosis. Of the 17 patients with available vaccination data, seven had received BCG vaccine. Among them, no child developed disseminated TB, while three in the unvaccinated group had disseminated disease. The researchers found no correlation between Mantoux reactivity and disease severity.

Sethi and colleagues reported that their study was limited by its small sample size.

“Preliminary results show protective efficacy of BCG vaccine in preventing hematogenous complications of primary infection and provide protection against disseminated cutaneous disease,” Sethi told Infectious Diseases in Children. “The main source of pediatric cutaneous tuberculosis is family members, and chemoprophylaxis needs to be more aggressively pursued in children with household cases of tuberculosis.” – by Will Offit

Reference:
Sethi S, et al. Abstract 3234. Presented at: American Academy of Dermatology Annual Meeting; March 4-8, 2016; Washington D.C.

Disclosure: Infectious Diseases in Children was unable to confirm relevant financial disclosures at the time of publication.