The relation of BCG vaccination and severe malnutrition with the occurrence of tuberculous meningitis
Keywords:
BCG vaccination, tuberculous meningitis, primary tuberculosis, severe malnutrition
Abstract
Objectives To assess BCG vaccination and nutritional states inchildren with tuberculous meningitis and their relations with the
occurrence of tuberculous meningitis.
Methods A case-control study was conducted at the Division
of Neurology, Department of Child Health, Adam Malik Hospi-
tal, Medan, from January 1997 to December 2000. Subjects of
this study were all tuberculous meningitis patients and primary
tuberculosis patients as the control group. Odds ratio (OR) was
used to assess the risk of tuberculous meningitis in patients
with positive BCG vaccination and (1-OR) was used to assess
the efficacy of BCG to prevent tuberculous meningitis.
Results Four out of sixteen tuberculous meningitis patients were
vaccinated, while 10 of 16 primary tuberculosis patients were vac-
cinated (p=0.03). OR of vaccinated patients to get tuberculous
meningitis was 0.2 (95%CI 0.04;0.91). The efficacy of BCG vacci-
nation to prevent tuberculous meningitis was 1-0.2 = 0.8. The risk
of severe malnourished patients to get tuberculous meningitis was
2.33 (95%CI 0.52;10.48; p=0.26).
Conclusion Most tuberculous meningitis patients were not BCG
vaccinated. Severe malnutrition did not play role in the occurrence
of this disease
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Soetomenggolo TS, Ismael S, editors. Buku ajar
neurologi anak. 1 st ed. Jakarta: Ikatan Dokter Anak
Indonesia; 1999. p. 363-71.
2. Ramachandran TS. Tuberculosis meningitis. Medicine
J 2002;7:1-33.
3. Tuberkulosis pada anak. In: Hasan R, Alatas H, edi-
tors. Buku kuliah ilmu kesehatan anak 2. Jakarta:
Bagian Ilmu Kesehatan Anak Fakultas Kedokteran
Indonesia; 2000. p. 573-91.
4. Inselman LS, Kendig EL, Tuberculosis. In: Chernick
V, Kendig EL, editors. Kendig’s disorders of the respi-
ratory tract in children. 5 th ed. Philadelphia: Saunders;
1990. p. 760-6.
5. Padungchan S, Konjanat S, Kasiratta S, Daramas S,
Ten Dam HG. The effectiveness of BCG vaccination
of the newborn against childhood tuberculosis in
Bangkok. Bull WHO 1986;64:247-58.
6. Fine PEM. Variation in protection by BCG: implica-
tion of and for heterologous immunity. Lancet
1995;346:1339-45.
7. Putrali J, Sutrisna B, Rahayu N, Gunardi AS,
Gunowiseso. Penelitian efektifitas vaksinasi BCG pada
anak-anak di 8 rumah sakit di Jakarta. Medika
1982;10:779-82.
8. Anonym. Profil kesehatan Republik Indonesia tahun
1998. Jakarta: Departemen Kesehatan dan Kesejah-
teraan Sosial RI; 1999.
9. Rahajoe NN. Tata laksana tuberkulosis pada anak. Sari
Pediatri 2001;1:24-35.
10. Starke JR, Munoz F. Tuberculosis. In: Behrman RE,
Kliegman RM, Jenson HB, editors. Nelson textbook of
pediatrics. 16 th ed. Philadelphia: Saunders; 2000. p.
885-97.
11. Musa DA. Keamanan dan indikasi kontra imunisasi
pada anak. In: Tjokronegoro A, Utama H, editors.
Strategi pemilihan dan penggunaan vaksin serta
antibiotika dalam upaya antisipasi perubahan pola
penyakit. Naskah lengkap PKB IKA XXXIX. Jakarta:
Balai penerbit FKUI; 1997. p. 65-75.
12. Fine PEM, Ponninghaus JM, Mane N. The distribu-
tion and implications of BCG scars in Northern
Malawi. Bull WHO 1989;67:35-42.
13. Bloch AB. Screening for tuberculosis and tuberculosis
infection in high risk populations. In. Fishman AP, Elias
OA, Fishman JA, Grippi MA, Kaiser LR, Senior RM,
editors. Fishman’s pulmonary diseases and disorders
volume 2. 3 rd ed. New York: McGraw-Hill; 1998. p.
2473-80.
14. Anonym. Baku rujukan antropometri, klasifikasi sta-
tus gizi dan batas ambangnya. Rekomendasi Semiloka
Antropometri di Indonesia; 1991 Feb 3-7; Ciloto, In-
donesia.
15. Molavi A, Le Frock JL. Tuberculous meningitis. Med
Clin North Am 1985;69:315-31.
16. Weil ML, Levin M. Infections of the nervous system.
In: Menkes JH, editor. Textbook of child neurology. 5 th
ed. Baltimore: Willliams and Wilkins; 1995. p. 401-5.
17. Kumar R, Singh SN, Kohli N. A diagnostic rule for
tuberculous meningitis. Arch Dis Child 1999;1:221-4.
18. Sanchez-Albisua I, Baquero-Artgao F, Castillo FD,
Borque C, Garcia-Miguel MJ, Vidal ML. Twenty years
of pulmonary tuberculosis in children: what has
changed? Pediatr Infect Dis J 2002;21:49-53.
19. Willingham FF, Schmitz TL, Contreras M, Kalangi
SE, Vivar M, Caviedes L, et al. Hospital control
and multidrug-resistant pulmonary tuberculosis in
female patients, Lima Peru. Emerg Infect Dis
2001;7:123-7.
20. Saiman L, Gabriel PS, Schulte J, Vargas MP, Kenyon T,
Onorato I. Risk factors for latent tuberculosis infec-
tion among children in New York City. Pediatrics
2001;107:999-1003.
21. Martinez-Gonzales MTG, Castellanos JLV, Meza FAG.
Effectiveness of the BCG vaccine to prevent severe
extra-pulmonary tuberculosis in children. Int Pediat-
rics 2002;17:110-4.
22. Aditama TY. Tuberkulosis: diagnosis, terapi dan
masalahnya. 4 th ed. Jakarta: Yayasan Penerbit Ikatan
Dokter Indonesia; 2002. p. 131
23. Bai SS, Devi RL. Clinical spectrum of tuberculosis in
BCG vaccinated children. Indian Pediatrics
2002;39:458-62.
24. Baratawijaya KG. Imunologi dasar. 4 th ed. Jakarta: Balai
Penerbit FKUI: 2000; p. 220.
25. Filho VW, de Castilho EA, Rodrigues LC, Hittly SR.
Effectiveness of BCG vaccination against tuberculous
meningitis: a case-control study in Sao Paulo Brazil.
Bull WHO 1990; 68:67-74.
26. Handojo RA, Liunanda S. Cell mediated immune re-
sponse terhadap Mycobacterium tuberculosis dan
kaitannya dengan penggunaan kemoterapi anti
tuberkulose. Medika 1982;10:872-8.
27. Matondang CS. Aspek imunologi imunisasi. In: Ranuh
IGN, Suyitno, Hadinegoro SRS, Kartasasmita C, edi-
tors. Buku imunisasi di Indonesia. 1 st ed. Jakarta: Satgas
Imunisasi – IDAI; 2001. p. 5-11.
Published
2016-10-10
How to Cite
1.
Nofareni N, Saing B, Daulay R, Lubis B. The relation of BCG vaccination and severe malnutrition with the occurrence of tuberculous meningitis. PI [Internet]. 10Oct.2016 [cited 25Apr.2024];44(1):12-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/726
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Received 2016-09-28
Accepted 2016-09-28
Published 2016-10-10
Accepted 2016-09-28
Published 2016-10-10
