|BCG WITHOUT TUBERCULIN TEST
|GD Gothi, Kul Bhushan, SS Nair & GVJ Baily: Proceed
19th Natl TB & Chest Dis Workers Conf, New Delhi, 1964, 138-62.
In the BCG Mass Campaign low outputs and coverages
of BCG vaccination done after tuberculin test were due to slowness
of the campaign because of two visits to an area, the fear of two
pricks and tuberculin tested absenting themselves from reading of
the test. It was thought that if BCG vaccination could be given
without prior tuberculin test and without causing any complications
then the speed of work and outputs could be more than doubled and
coverages improved appreciably. For this, the following three studies
were carried out: In the first study 1,891 persons belonging
to a rural population were randomly divided into four groups (i)
those tuberculin tested and vaccinated, (ii) tested but not vaccinated,
(iii) not tested but vaccinated, and (iv) neither tested nor vaccinated.
Induration site of tuberculin test and vaccination were read on
the 3rd, 6th and 90th day. Later on, another tuberculin test was
done on the 90th day and read 3 days later. Both axillae were examined
on 0, 14th and 90th day and X-ray pictures were taken on 0 day,
90th day and after one year. Tuberculin indurations on 3rd day were
compared with BCG induration on 3rd, 6th, 14th and 90th day. Majority
of tuberculin reactors had large BCG indurations upto 14th day.
By 90th day very few persons have large indurations left. Among
non-reactors also large BCG reactions were seen in 25%-53% of the
persons. There were no differences as regards to the size of lymph
nodes (regional reactions) between reactors and non-reactors; neither
was there any evidence of exacerbation of existing disease nor any
flaring up of dormant foci (Primary complex) in the form of new
disease as shown by X-ray.
In the second study out of 1,520 persons
from 4 villages, 1,186 were both tuberculin tested and simultaneously
vaccinated. Examination of local reactions daily from one to
nine days, on 19th and the 29th day, confirmed the findings of first
study with regard to the local reactions. In this study neither
axillae were examined nor X-ray pictures taken. In the third
study, influence on acceptability of direct BCG vaccination
due to large local reactions was tested. Twelve villages in Gubbi
taluk of Tumkur district were taken in pairs. Vaccination of 2nd
village of each pair was done after 1-4 weeks of the vaccination
in lst village to observe the influence of BCG reaction on the people.
Vaccinations were given to 5363 (64.2%) persons from the total registered
population with Madras liquid vaccine. The large local reactions
showed no adverse effect on the acceptability of BCG vaccination
in the neighbouring villages, rather a slight improvement in BCG
vaccination coverages with time was seen.
|KEY WORDS: RURAL POPULATION, DIRECT BCG VACCINATION,