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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Tuberculosis, bacillus Calmette-Guérin vaccination, and allergic disease: Findings from the International Study of Asthma and Allergies in Childhood Phase Two
Pediatric Allergy and Immunology, Volume 23, No. 4, Year 2012
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Description
Some have suggested a protective effect of tuberculosis (TB) infection on allergic disease risk, but few studies have examined the association between the two. We therefore investigated whether TB disease and bacillus Calmette-Guérin (BCG) vaccination in early life protect against allergic disease. Information on allergic disease symptoms, past TB disease, and BCG vaccination as well as potential confounding factors was gathered by parental questionnaire from a randomly selected subset of 23,901 8- to 12-yr-old schoolchildren in 20 centers in both developed and developing countries. Children were also physically examined for flexural eczema and underwent skin prick testing. Pooled odds ratio (OR) estimates and corresponding 95% confidence intervals (CIs) across study centers were calculated, using random effects meta-analysis models. There were 245 (1.0%) reported cases of TB disease, and 66.3% (15,857) of all children received the BCG vaccine. Asthma, hay fever, and flexural eczema symptoms in the past year as well as flexural eczema on skin examination were all positively linked to a history of TB (adjusted pooled OR 'wheeze in the past year'=2.27, 95% CI 1.52-3.41; adjusted pooled OR 'hay fever symptoms in the past year'=2.23, 1.22-4.09; adjusted pooled OR 'flexural eczema symptoms in the past year'=3.21, 2.01-5.12; adjusted pooled OR 'flexural eczema on skin examination'=4.04, 1.71-9.56). Even higher risk estimates were seen for severe asthma and eczema symptoms [adjusted OR=4.02 (2.17-7.47) and adjusted OR=6.31 (2.19-18.17), respectively]. There was no significant association between past TB and skin prick test positivity (adjusted pooled OR=1.32, 0.87-2.02). BCG vaccination during the first year of life was also not associated with any of the allergy outcomes. We found a uniform positive association between TB and all allergic disease outcomes, including eczema on skin examination. As this was a cross-sectional study, it is unclear whether this positive association is attributable to a causal relationship, and further longitudinal studies are required. © 2011 John Wiley & Sons A/S.
Authors & Co-Authors
Flohr, C.
United Kingdom, London
St John's Institute of Dermatology
Nagel, Gabriële C.
Germany, Ulm
Universität Ulm
Weinmayr, Gudrun
Germany, Ulm
Universität Ulm
Kleiner, A.
Germany, Ulm
Universität Ulm
Williams, Hywel C.
United Kingdom, Nottingham
University of Nottingham
Aït-Khaled, Nadia
Algeria, Algiers
International Union Against Tuberculosis and Lung Disease the Union
Strachan, David Peter
United Kingdom, London
St George’s, University of London
Büchele, Gisela
Germany, Ulm
Universität Ulm
Genuneit, Jon
Germany, Ulm
Universität Ulm
Priftanji, Alfred V.
Unknown Affiliation
Shkurti, A.
Unknown Affiliation
Simenati, J.
Unknown Affiliation
Grabocka, E.
Unknown Affiliation
Shyti, K.
Unknown Affiliation
Agolli, S.
Unknown Affiliation
Gurakuqi, A.
Unknown Affiliation
Stein, Renato Tetelbom
Unknown Affiliation
De Pereira, M. Urrutia
Unknown Affiliation
Jones, M. H.
Unknown Affiliation
Pitrez, Paulo Márcio Condessa
Unknown Affiliation
Cooper, Philip John
Unknown Affiliation
Chico, Martha E.
Unknown Affiliation
Chen, Yuzhi
Unknown Affiliation
Zhong, Nanshan
Unknown Affiliation
Lai, C.
Unknown Affiliation
Wong, Gary Wing Kin
Unknown Affiliation
Riikjärv, Mall Anne
Unknown Affiliation
Annus, T.
Unknown Affiliation
Annesi-Maesano, Isabella I.
Unknown Affiliation
Gotua, Maia A.
Unknown Affiliation
Rukhadze, M.
Unknown Affiliation
Abramidze, T.
Unknown Affiliation
Kvachadze, I.
Unknown Affiliation
Karsanidze, L.
Unknown Affiliation
Kiladze, M.
Unknown Affiliation
Dolidze, M. N.
Unknown Affiliation
Leupold, W.
Unknown Affiliation
Keil, Ulrich
Unknown Affiliation
von Mutius, Erika R.M.
Unknown Affiliation
Weiland, Stephan Karl
Unknown Affiliation
Arthur, Paul
Unknown Affiliation
Addo-Yobo, Emmanuel O.D.
Unknown Affiliation
Gratziou, Christina G.
Unknown Affiliation
Priftis, C.
Unknown Affiliation
Papadopoulou, A.
Unknown Affiliation
Katsardis, C.
Unknown Affiliation
Tsanakas, John N.
Unknown Affiliation
Hatziagorou, E.
Unknown Affiliation
Kirvassilis, F.
Unknown Affiliation
Clausen, M.
Unknown Affiliation
Shah, Jayant R.
Unknown Affiliation
Mathur, R. S.
Unknown Affiliation
Khubchandani, Raju P.
Unknown Affiliation
Mantri, S. N.
Unknown Affiliation
Forastiére, Francesco
Unknown Affiliation
Di Domenicantonio, R.
Unknown Affiliation
De Sario, Manuela
Unknown Affiliation
Sammarro, S.
Unknown Affiliation
Pistelli, R.
Unknown Affiliation
Serra, M. G.
Unknown Affiliation
Corbo, G.
Unknown Affiliation
Perucci, C. A.
Unknown Affiliation
Švabe, Vija
Unknown Affiliation
Sebre, D.
Unknown Affiliation
Casno, G.
Unknown Affiliation
Novikova, I.
Unknown Affiliation
Bagrade, L.
Unknown Affiliation
Brunekreef, Bert A.
Unknown Affiliation
Schram, D.
Unknown Affiliation
Doekes, G.
Unknown Affiliation
Jansen-Van Vliet, P. H.N.
Unknown Affiliation
Janssen, Nicole A.H.
Unknown Affiliation
Aarts, F. J.H.
Unknown Affiliation
De Meer, G.
Unknown Affiliation
Crane, Julian
Unknown Affiliation
Wickens, K.
Unknown Affiliation
Barry, David M.J.
Unknown Affiliation
Nystad, Wenche
Unknown Affiliation
Bolle, R.
Unknown Affiliation
Lund, Eiliv
Unknown Affiliation
El-Sharif, Nuha A.
Unknown Affiliation
Nemery, B.
Unknown Affiliation
Barghuthy, F.
Unknown Affiliation
Abu Huij, S.
Unknown Affiliation
Qlebo, M.
Unknown Affiliation
Batllés-Garrido, José
Unknown Affiliation
Rubi Ruiz, T.
Unknown Affiliation
Perales, A. Bonillo
Unknown Affiliation
Gonzalez Jiménez, Y.
Unknown Affiliation
Aguirre Rodriguez, J.
Unknown Affiliation
Momblan de Cabo, J.
Unknown Affiliation
Losilla Maldonado, A.
Unknown Affiliation
Daza Torres, M.
Unknown Affiliation
García-Marcos, Luis
Unknown Affiliation
Martinez-Torres, Antonela
Unknown Affiliation
Guillén Pérez, J. J.
Unknown Affiliation
Piñana López, A.
Unknown Affiliation
Castejon Robles, S.
Unknown Affiliation
García-Hernández, Gloria
Unknown Affiliation
Martinez Gimeno, A.
Unknown Affiliation
Statistics
Citations: 100
Authors: 100
Affiliations: 5
Identifiers
Doi:
10.1111/j.1399-3038.2011.01248.x
ISSN:
09056157
e-ISSN:
13993038
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Case-Control Study
Study Approach
Quantitative
Systematic review