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American Journal of Epidemiology Vol. 131, No. 2: 340-348
Copyright © 1990 by The Johns Hopkins University School of Hygiene and Public Health


research-article

THE EFFECTIVENESS OF BACILLUS CALMETTE-GUERIN (BCG) VACCINATION AGAINST TUBERCULOSIS

A CASE-CONTROL STUDY IN TREATY INDIANS, ALBERTA, CANADA

STAN HOUSTON1, ANNE FANNING2,, COLIN L. SOSKOLNE3 and NONIE FRASER4

1University of Zimbabwe, Department of Clinical Pharmacology Harare, Zimbabwe
2Department of Medicine. University of Alberta Edmonton, Alberta, Canada
3Department of Health Services Administration and Community Medicine, University of Alberta Edmonton, Alberta, Canada
4Edmonton Board of Health Edmonton, Alberta, Canada

Reprint requests to Dr. Anne Fanning, Division of Infectious Diseases, Department of Medicine, 2E4.11 Walter MacKenzie Health Sciences Centre, University of Alberta, Edmonton, Alberta, Canada T6G 2B7

Bacillus Calmette-Guérin (BCG) vaccination against tuberculosis has been used around the world for 60 years, yet its efficacy in large, controlled prospective studies is inconsistent. The factors influencing BCG protection include variation in immunogenic potential, background exposure to environmental mycobactena, and differences in host response to vaccine. As a means of addressing regional differences in protection, case-control studies provide a relatively inexpensive, rapid means of assessing regional vaccine effects. Treaty Indian cases (n = 160) resident in Alberta, Canada, presenting during a 5-year period (1975–1979) were individually matched for age, sex, and Band with two nontuberculous controls. A 57 percent protection by BCG vaccination was demonstrated. These results support the usefulness of case-control studies and their importance in planning tuberculosis control programs.

BCG vaccine; Indians, North American; population; public health; retrospective studies; tuberculosis; vaccination


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