Community-Based TB Detection and BCG Vaccine

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Questions and Answers

What is the primary benefit of BCG vaccination?

Protection against severe forms of TB (correct)

Reduction of all TB forms in adults

Complete elimination of TB infections

Increased immunity in HIV-negative individuals

What is the estimated protective efficacy of BCG against severe TB in infants immunized during the neonatal period?

75%

90% (correct)

85%

95%

Which of the following adverse events is commonly associated with BCG vaccination?

Hypersensitivity reactions and ulceration (correct)

Severe allergic reactions

Infection with HIV

Permanent disability

What is the case-fatality rate associated with disseminated BCG disease?

70% Signup and view all the answers

What are the clinical features of disseminated BCG disease?

Failure to thrive and lymphadenitis Signup and view all the answers

How is disseminated BCG disease usually managed?

Antibiotics including isoniazid and rifampicin Signup and view all the answers

What is a typical outcome of BCG vaccination at the site of injection?

Scar formation but not an indicator of protection Signup and view all the answers

What is the current World Health Organization (WHO) recommendation for BCG vaccination?

To administer a single dose to healthy neonates at birth Signup and view all the answers

What was the reduction in TB prevalence achieved in the intervention clusters during the ACT3 study compared to standard passive detection?

44% Signup and view all the answers

Which age group of children showed a significant reduction in TBI prevalence post-intervention?

Older children (3-10 years) Signup and view all the answers

What type of vaccine is BCG and what does it use to fight TB?

Live, attenuated vaccine using Mycobacterium bovis Signup and view all the answers

How many countries reported BCG as part of their national childhood vaccine schedule as of 2020?

154 Signup and view all the answers

What demographic was primarily described as benefiting from the community-based active TB screening and treatment in Vietnam?

Older children (3-10 years) Signup and view all the answers

What is the significance of BCG vaccine in low-resource countries according to the content?

It is considered highly cost-effective in high-TB burden areas. Signup and view all the answers

What type of trials have been mentioned as finding and treating both active TB disease and TBI?

Modeling studies and randomized clinical trials Signup and view all the answers

What is the approximate vaccination coverage for BCG reported by most countries in 2020?

90% Signup and view all the answers

Study Notes

Community-Based Active TB Case Detection and Treatment

Reducing the number of TB cases in a community can significantly reduce the risk of TB exposure and infection in children.
A study in Vietnam demonstrated that community-wide active TB screening and treatment led to a 44% reduction in TB prevalence.
The study also showed a 50% reduction in TB infection (TBI) among older children in intervention clusters.
This suggests that community-based interventions are effective in reducing TB transmission and have a greater impact on older children who are more likely to interact within the community.

BCG Vaccine

BCG vaccine is a live, attenuated vaccine using Mycobacterium bovis, a mycobacterium species that causes TB in cattle.
It was launched over 100 years ago and is part of the national childhood vaccine schedule in 154 countries.
BCG is one of the most widely used vaccines globally and is highly cost-effective in low-resource countries with high TB burdens.
The vaccine primarily protects against severe forms of TB such as TBM and miliary TB, particularly in young children.
Randomized clinical trials indicate that BCG has 85% protective efficacy against severe forms of TB, with the highest protection found in infants immunized during the neonatal period.
BCG vaccination typically forms a scar at the injection site, but this isn't a marker for protection.
Severe adverse events are rare and generally self-limited.
Disseminated BCG disease is particularly prevalent in children living with HIV and those with primary immunodeficiencies.
Rates of disseminated BCG disease have decreased significantly since the implementation of early antiretroviral therapy for HIV-infected infants.
Disseminated BCG disease shares clinical features with TB, including failure to thrive, anemia, hepatosplenomegaly, lymphadenitis, osteomyelitis, and pneumonia.
Management of disseminated BCG disease usually involves a combination of isoniazid, rifampicin, and ethambutol, with or without a fluoroquinolone.
BCG is resistant to pyrazinamide, and some strains are partially resistant to isoniazid.

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Description

This quiz explores the effectiveness of community-based active TB case detection and treatment in reducing the prevalence of tuberculosis, especially among children. It also covers the history and significance of the BCG vaccine in combating TB globally.