Effectiveness of Bacillus Calmette-Guerin for Tuberculosis PreventionAmong Chinese People: Systematic Review and Meta-analysis

摘要

Background: Our previous study showed that the protective effect of Bacillus Calmette-Guerin (BCG) declinedwith time, which is supported by a following study saying "BCG vaccination protection against tuberculosis variesbetween populations, to an extent that cannot be attributed to chance alone". Objective: To investigate BCG protectiveeffect among Chinese people, so as to update the development and use of immunological agents. Methods: Systematicreview was carried out: electronic databases searches, screening of identified studies based on inclusion and exclusioncriteria, data extraction and meta-analysis were undertaken. Results: Initial search identified 3067 articles from fourChinese databases, after selection, 25 met the eligibility criteria among which 6 were cohort studies and 19 were casecontrolstudies, with the total participant of 1311758 and 5169 respectively. None of the experimental studies such asrandomized controlled trials (RCTs) were identified. The P value of Egger's test was 0.016 for cohort studies and 0.067for case-control studies, which, together with funnel plot, indicated that the available evidences were at risk of publicationbias. The pooled estimate of RR for cohort studies was 0.24, with 95% confidence interval (95%CI) (0.11, 0.52), and ofOR for case-control studies it was 0.37 with 95%CI (0.31,0.45). Conclusions: The available evidence shows positive anddefinite effect of BCG in preventing TB among Chinese people but it should be supported by more studies to avoidpublication bias risk. High quality studies are encouraged worldwide to update the development and use of immunologicalagents to cope with tuberculosis epidemiology.