Protective effects of BCG vaccination against multibacillary disease, reactions, and disabilities in childhood leprosy: Insights from a retrospective observational study from a tertiary care center in India

IF 3.2 4区医学 Q1 DERMATOLOGY International Journal of Dermatology Pub Date : 2025-01-05 DOI:10.1111/ijd.17636

Tarun Narang, Apoorva Sharma, Ishita Kaushal, Debajyoti Chatterjee, Sunil Dogra

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Abstract

Background and methods

While leprosy primarily affects adults, childhood leprosy poses unique challenges because of its potential to cause lifelong disabilities and stigma. This is a retrospective record review of all patients aged 15 or below, diagnosed with leprosy, who were registered at the leprosy clinic of our tertiary care center from June 2014 to December 2023.

Results

As per hospital records, 1083 leprosy cases were registered at our center during the study period. Of these, 50 (4.6%) were children below 15 years of age. Persistent skin lesions (PSL) were seen in 11 (22%) cases, and the most common spectrum in which PSL were seen was the bordeline tuberculoid spectrum (BT) (7/11; 63.6%). Among these cases, a Bacillus Calmette-Guerin (BCG) scar was present in only four (36.4%) patients. Overall, a BCG scar was noted in 39/50 cases (78%). The relationship between having no BCG scar and multibacillary disease, lepromatous leprosy (LL), or the borderline lepromatous (BL) spectrum was statistically significant (P = 0.021). Of the six reaction cases, only one patient had a BCG scar (2%). A statistically significant association was found between the absence of a BCG scar and having a reaction (P < 0.01). Of the 11 grade 2 disability cases, nine cases (all within the BL or LL spectrum) had no BCG scar, which was also statistically significant (P < 0.01).

Conclusions

Further research is warranted to strengthen the evidence of the impact of vaccination [BCG/Mycobacterium indicus pranii (MIP)] on the patterns of childhood leprosy, its effect on PSL, and its role in the prevention of reactions and disabilities. Such research would also help in optimizing strategies for the vaccine's universal application.

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卡介苗接种对儿童麻风病多菌病、反应和残疾的保护作用：来自印度三级保健中心的回顾性观察研究的见解。

背景和方法：虽然麻风病主要影响成年人，但儿童麻风病带来了独特的挑战，因为它有可能导致终身残疾和耻辱。这是对2014年6月至2023年12月在我院三级保健中心麻风病门诊登记的所有年龄在15岁及以下诊断为麻风病的患者的回顾性记录回顾。结果：根据医院记录，在研究期间，我中心共登记了1083例麻风病例。其中，50人（4.6%）是15岁以下的儿童。11例（22%）出现持续性皮肤病变，其中最常见的是边界结核菌谱（BT） (7/11；63.6%)。在这些病例中，只有4例（36.4%）患者出现卡介苗疤痕。总体而言，39/50例（78%）出现卡介苗疤痕。无卡介苗瘢痕与多菌病、麻风病（LL）、边缘性麻风病（BL）谱的关系有统计学意义（P = 0.021）。在6例反应病例中，只有1例患者有卡介苗疤痕（2%）。结论：需要进一步的研究来加强疫苗接种[BCG/ indicus pranii (MIP)]对儿童麻风病模式的影响，其对PSL的影响，以及其在预防反应和残疾中的作用。这种研究还将有助于优化疫苗普遍应用的策略。

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来源期刊

International Journal of Dermatology 医学-皮肤病学

CiteScore

4.70

自引率

2.80%

发文量

476

审稿时长

3 months

期刊介绍： Published monthly, the International Journal of Dermatology is specifically designed to provide dermatologists around the world with a regular, up-to-date source of information on all aspects of the diagnosis and management of skin diseases. Accepted articles regularly cover clinical trials; education; morphology; pharmacology and therapeutics; case reports, and reviews. Additional features include tropical medical reports, news, correspondence, proceedings and transactions, and education. The International Journal of Dermatology is guided by a distinguished, international editorial board and emphasizes a global approach to continuing medical education for physicians and other providers of health care with a specific interest in problems relating to the skin.