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Epidemiology of tuberculosis - reaction on vaccine BCG
FOŠUM, Pavel
Epidemiology of tuberculosis-reaction to BCG vaccine World Health Organization records nine million people worldwide who fall ill with tuberculosis and more than three million who die of this disease a year. Tuberculosis has been known for a long time and despite the discovery of Mycobacterium tuberculosis etiological role by Robert Koch, the invention of RTG diagnostics by Roentgen and effective treatment using antibiotics by Waksman as the first, this disease still represents a considerable risk for society. Prevention using BCG vaccine has positive as well as negative aspects. This thesis is focused on describing newborn vaccination coverage, occurrence and duration of side and adverse effects after the application of BCG vaccine during the first days of life and on the influence on the following compulsory vaccination. We used the method of quantitative research in the form of epidemiology descriptive study using the technique of individual data collection and analysis. As a research area the group of children born in 2004, 2005, and 2006 was used. The group of 804 children (410 boys and 393 girls) was selected by the technique of random cluster sampling. We found out that out of 804 respondents 98.6 % were vaccinated with BCG vaccine. The group of 11 children was not vaccinated due to: HBsAg positivity of mother, low birth weight or health problems. Reaction after BCG vaccination was not healed until the next planed shot in 307 children (38.1 %). There were 4 people with no reaction at all to BCG (0.8%). The most frequent side (adverse) reaction after vaccination was scar unhealed at the time of next planed vaccination in 274 cases, (34.1%). Monoreactions accounted for more than a half of recorded reactions. Reaction time period was in the range from 11 to 300 days. Median of reaction time period was 30 days. We did not find any serious adverse reaction. Our research demonstrated, that frequency of side and adverse reactions after BCG vaccination is high (38.1 %). These are mainly benign side effects. We found that these reactions lead to postponing of the subsequent vaccination of the compulsory vaccination scheme in all who reacted to BCG vaccination. The occurrence of side reactions after BCG vaccine raises the question of appropriateness to carry out the BCG vaccination in first days of life. The results of this thesis can be used as a pilot study for the whole country study of mapping side and adverse reactions and further consideration of compulsory vaccination scheme.
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