BCG Vaccination as a Prevention Strategy, Threats and Benefits

Abstract

Context: Tuberculosis is still one of the deadliest communicable diseases. Objectives: Nine million people worldwide developed TB in 2013, and 1.5 million people died from it, 360000 of which were HIV positive. Although the disease is controllable by means of diagnostic and treatment measures, the death toll from the disease is still high, and efforts to combat it must be accelerated. Data Sources: Data compiled from 202 countries in the Global Tuberculosis Report 2014 showed that TB is present in all regions of the world. Study Selection: Higher numbers of tuberculosis cases were diagnosed in 2013 in comparison with previous reports, indicating that diagnoses and reports of new cases may be improved by stringent data collection. Data Extraction: A special note to the 2014 report highlighted the progress of drug resistant TB during the last two decades. Results: Worldwide, a proportion of new cases with multidrug-resistant TB (MDR-TB) were reported at 3.5% in 2013 without a significant change compared with recent years. Interestingly, higher levels of resistance and poor treatment outcomes are of major concern in some parts of the world. Due to this concern, special attention is focused on prevention rather than treatment. On the other hand, the effectiveness of an existing vaccine (BCG) is increasingly questionable. Conclusions: It has the potential to cause disseminated infection, and an increasing number of immunocompromised patients prone to disease and the suboptimal preventive potency of this vaccine suggest the need for a global attempt to review its benefits and disadvantages.