HIV, BCG AND TB IN CHILDREN - A CASE-CONTROL STUDY IN LUSAKA, ZAMBIA

Even before the onset of the HIV epidemic, studies reported large vari ations in the protective effect of BCG against TB. The current HIV/AID S epidemic has increased the incidence of tuberculosis in many countri es in sub-Saharan Africa. Thus, local estimates of the effectiveness o f BCG are needed which take prevalence of HIV into account for plannin g strategies for vaccination and TB control programmes. A case control study was conducted in Lusaka, Zambia. The study included 116 TB case s and 154 hospital controls. Eighty-eight per cent of controls had BCG scars compared to 77 per cent of the cases. BCG was not associated wi th TB in HIV positive children (OR 1.0, 95 per cent CI 0.2, 4.6). Howe ver, there was 59 per cent protective effect (OR 0.41, 95 per cent CI 0.18, 0.92) in HIV negative children. The results also suggest an eigh t times higher risk of TB in HIV positive children.