@article{92,
  keywords = {Adolescent, BCG Vaccine, Brazil, Child, Female, Humans, Incidence, leprosy, Male, Vaccination},
  author = {Cunha S and Alexander N and Barreto M and Pereira E and Dourado I and Maroja MF and Ichihara M and Brito SC and Pereira S and Rodrigues L},
  title = {BCG revaccination does not protect against leprosy in the Brazilian Amazon: a cluster randomised trial.},
  abstract = {<p><b>BACKGROUND: </b>Although BCG has been found to impart protection against leprosy in many populations, the utility of repeat or booster BCG vaccinations is still unclear. When a policy of giving a second BCG dose to school children in Brazil was introduced, a trial was conducted to assess its impact against tuberculosis, and a leprosy component was then undertaken in parallel.</p><p><b>OBJECTIVE: </b>to estimate the protection against leprosy imparted by a second dose of BCG given to schoolchildren.</p><p><b>METHODS AND FINDINGS: </b>This is a cluster randomised community trial, with 6 years and 8 months of follow-up.</p><p><b>STUDY SITE: </b>City of Manaus, Amazon region, a leprosy-endemic area in Brazil.</p><p><b>PARTICIPANTS: </b>99,770 school children with neonatal BCG (aged 7-14 years at baseline), of whom 42,662 were in the intervention arm (revaccination).</p><p><b>INTERVENTION: </b>BCG given by intradermal injection.</p><p><b>MAIN OUTCOME: </b>Leprosy (all clinical forms).</p><p><b>RESULTS: </b>The incidence rate ratio of leprosy in the intervention over the control arm within the follow-up, in schoolchildren with neonatal BCG, controlled for potential confounders and adjusted for clustering, was 0.99 (95% confidence interval: 0.68 to 1.45).</p><p><b>CONCLUSIONS/SIGNIFICANCE: </b>There was no evidence of protection conferred by the second dose of BCG vaccination in school children against leprosy during the trial follow-up. These results point to a need to consider the effectiveness of the current policy of BCG vaccination of contacts of leprosy cases in Brazilian Amazon region.</p>},
  year = {2008},
  journal = {PLoS neglected tropical diseases},
  volume = {2},
  pages = {e167},
  month = {2008 Feb 13},
  issn = {1935-2735},
  url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2238709/pdf/pntd.0000167.pdf},
  doi = {10.1371/journal.pntd.0000167},
  language = {eng},
}