| Abstract | In a meta-analysis of the efficacy of BCG vaccine for preventing tuberculosis, study sites at a greater distance from the equator were associated with a higher efficacy. In a random-effects regression analysis of prospective studies, geographic latitude alone accounted for 41% of the between-study variance. Many factors that vary with latitude may influence the effectiveness of BCG vaccine by modifying the susceptibility of human hosts, the pathogenecity of the organism, or host-agent interactions. These factors include socioeconomic conditions, genetic composition of the population, climate, exposure to sunlight, diet and nutrition, presence of nontuberculous mycobacteria in the environment, completeness of surveillance and follow-up in studies of BCG vaccine, virulence of locally prevalent strains of Mycobacterium tuberculosis, and storage and viability of BCG vaccine. This paper describes the biological plausibility, epidemiologic evidence, and other scientific data bearing on the influence of these factors on the efficacy of BCG vaccine. |
| Authors | M E Wilson, H V Fineberg, G A Colditz
(Affiliation: Department of Medicine, Mount Auburn Hospital, Cambridge, Massachusetts 02238, USA.)
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| Journal | Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
(Clin Infect Dis)
Vol. 20
Issue 4
Pg. 982-91
(Apr 1995)
ISSN: 1058-4838 UNITED STATES |
| PMID | 7795103
(Publication Type: Journal Article, Meta-Analysis, Research Support, U.S. Gov't, P.H.S.)
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| Chemical References |
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| Topics |
- Animals
- BCG Vaccine
- Climate
- Drug Storage
- Geography
- Humans
- Mass Screening
- Mycobacterium Infections
(epidemiology, genetics, prevention & control)
- Regression Analysis
- Sunlight
- Tuberculin Test
- Tuberculosis
(epidemiology, genetics, prevention & control)
- Virulence
- Vitamin D
(radiation effects)
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