@article{1312,
  keywords = {Adult, BCG Vaccine, Case-Control Studies, Cicatrix, Female, Humans, India, leprosy, Male, Odds Ratio, Program evaluation, Vaccination},
  author = {Zodpey S P and Ambadekar N N and Thakur A},
  title = {Effectiveness of Bacillus Calmette Guerin (BCG) vaccination in the prevention of leprosy: a population-based case-control study in Yavatmal District, India.},
  abstract = {<p><b>OBJECTIVE: </b>To estimate the effectiveness of Bacillus Calmette Guerin (BCG) vaccination in the prevention of leprosy. Study design. Population-based case-control study.</p><p><b>METHODS: </b>The study was carried out in Yavatmal District, Maharashtra, India. It included 364 cases of leprosy (diagnosed by the World Health Organization's criteria), born since 1962, that were detected during a leprosy survey conducted by the Government of Maharashtra in 2,175,514 people. Each case was pair-matched with one neighbourhood control for age, sex and socio-economic status. Exclusion criteria for controls included past or current history of tuberculosis or leprosy. BCG vaccination status was assessed by examination for the presence of a BCG scar, immunization records if available and information from subjects/parents of children. Subjects who were uncertain about BCG vaccination were not included.</p><p><b>RESULTS: </b>A significant protective association between BCG and leprosy was observed [odds ratio=0.46, 95% confidence intervals (CI) 0.34-0.61]. Overall vaccine effectiveness (VE) was 54% (95% CI 39-66). BCG effectiveness against multibacillary, paucibacillary and single skin lesion leprosy was 68% (95% CI 26-86), 57% (95% CI 29-74) and 48% (95% CI 22-65), respectively. Analysis of linear trend revealed a significant linear association between the protective effect of BCG and the type of leprosy. The BCG vaccine was more effective in those aged < or =20 years compared with those aged >20 years (VE 61%, 95% CI), among females compared with males (VE 60%, 95% CI), in lower socio-economic strata compared with upper and middle strata (VE 57%, 95% CI), and in subjects who had a BCG scar size < or =5 mm compared with those with a BCG scar size >5 mm (VE 61%, 95% CI). However, these differences were not statistically significant, as reflected by the overlapping 95% CIs. The overall prevented fraction was 35% (95% CI 22-46).</p><p><b>CONCLUSION: </b>The current study identified a beneficial role of BCG vaccination in the prevention of leprosy in the study population.</p>},
  year = {2005},
  journal = {Public health},
  volume = {119},
  pages = {209-16},
  month = {2005 Mar},
  issn = {0033-3506},
  doi = {10.1016/j.puhe.2004.04.007},
  language = {eng},
}