International Union for Circumpolar Health Ministry of Public Health and Social Development of RF Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Medical Sciences Siberian Branch of Russian Academy of Sciences Medical Polar Fund “Science” The Northern Forum

Abstracts

Seminar Infection Diseases in Arctic

BCG vaccination is one of the most efficient ways of preventing childhood tuberculosis in Russia. For decades BCG immunization has been a nation-wide procedure in russian health care system, and has not undergone any profound modification since.

In Yakutia, BCG was first used in 1946, and resulted later in notable dicrease of childhood mortality due to tuberculosis. In 1962 an intradermal vaccination technique started to be used. Later, preventive immunization schedules were introduced to routine practice. A special emphasis has been put on the assessment of quality and efficiency of vaccination, defined in terms of the size of post-vaccinal scar.

According to current all-Russia immunization schedule, children in Yakutia are vaccinated at day 3-7, and later at age 7 and 14. Annual mean coverage rates for neonatal BCG vaccination, first revaccination, and second revaccination are: 96.9%, 95.7%, and 92.7% respectfully. Childhood population in Yakutia is above 220.000, and it takes nearly 2000 specially allocated paramedical workers to cover them.

Despite good coverage level, high incidence of childhood tuberculosis persisted. In 2005 incidence was 47.8/100.000 (in 2004 - 56.7) - higher than that in Russia by a factor of 3 (federal rate in 2004 was 16.6). We studied the efficiency of BCG vaccination in adverse weather and life conditions of Yakutia.

We found out that the quality of BCG vaccination has been declining in Yakutia. 40% of the vaccinated children had poor post-vaccinal scars. In 25% BCG failed and tuberculosis developed. Intradermal vaccination is a manual technique, and requires a flawless skill. Since it requires also large number of medical personnel, a uniform quality of BCG in all vaccinated cases can hardly be expected. In conclusion, adverse life conditions play a role in reduced efficiency of BCG. As a result, impact of vaccination on epidemiology of tuberculosis was insignificant. Nevertheless, BCG vaccination is still necessary, as life conditions in Yakutia improve extremely reluctantly. In the future, when life conditions will be better, BCG vaccination and revaccination might be repeated less often or might be completely cancelled.

Note. Abstracts are published in author's edition

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Last update: 06-Jul-2012 (11:52:05)