Last data update: Sep 16, 2024. (Total: 47680 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Aitmagambetova I [original query] |
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Comparative tuberculosis (TB) prevention effectiveness in children of Bacillus Calmette-Guerin (BCG) vaccines from different sources, Kazakhstan
Favorov M , Ali M , Tursunbayeva A , Aitmagambetova I , Kilgore P , Ismailov S , Chorba T . PLoS One 2012 7 (3) e32567 BACKGROUND: Except during a 1-year period when BCG vaccine was not routinely administered, annual coverage of infants with Bacillus Calmette-Guerin (BCG) in Kazakhstan since 2002 has exceeded 95%. BCG preparations from different sources (Japan, Serbia, and Russia) or none were used exclusively in comparable 7-month time-frames, September through March, in 4 successive years beginning in 2002. Our objective was to assess relative effectiveness of BCG immunization. METHODS/FINDINGS: We compared outcomes of birth cohorts from the 4 time-frames retrospectively. Three cohorts received vaccine from one of three manufacturers exclusively, and one cohort was not vaccinated. Cohorts were followed for 3 years for notifications of clinical TB and of culture-confirmed TB, and for 21 months for TB meningitis notifications. Prevention effectiveness based on relative risk of TB incidence was calculated for each vaccinated cohort compared to the non-vaccinated cohort. Although there were differences in prevention effectiveness observed among the three BCG vaccines, all were protective. The Japanese vaccine (currently used in Kazakhstan), the Serbian vaccine, and the Russian vaccine respectively were 69%, 43%, and 22% effective with respect to clinical TB notifications, and 92%, 82%, and 51% effective with respect to culture confirmed TB. All three vaccines were >70% effective with respect to TB meningitis. LIMITATIONS: Potential limitations included considerations that 1) the methodology used was retrospective, 2) multiple risk factors could have varied between cohorts and affected prevention effectiveness measures, 3) most cases were clinically diagnosed, and TB culture-positive case numbers and TB meningitis case numbers were sparse, and 4) small variations in reported population TB burden could have affected relative risk of exposure for cohorts. CONCLUSIONS/SIGNIFICANCE: All three BCG vaccines evaluated were protective against TB, and prevention effectiveness varied by manufacturer. When setting national immunization policy, consideration should be given to prevention effectiveness of BCG preparations. |
Tuberculosis deaths averted by implementation of the DOTS strategy in Kazakhstan
Favorov M , Belilovsky E , Aitmagambetova I , Ismailov S , White ME , Chorba T . Int J Tuberc Lung Dis 2010 14 (12) 1582-8 SETTING: Kazakhstan began implementing the DOTS strategy for tuberculosis (TB) in 1998. OBJECTIVE: Data were analyzed 1) to determine if changes in TB mortality rate (MR) and case fatality rate (CFR) in Kazakhstan for 1998-2003 differed from those of Uzbekistan and four adjacent Russian Federation (RF) oblasts that had not yet implemented DOTS, and 2) to estimate the number of deaths averted in Kazakhstan as a result of DOTS. DESIGN: Observed MRs were calculated, and predicted MRs for Kazakhstan were approximated by linear regression based on average slope of MRs from 1998 through 2003 in adjacent non-DOTS-implementing territories. Deaths averted were calculated by comparing predicted MRs to actual MRs by converting rate differences to numbers of deaths. RESULTS: TB MRs in Kazakhstan decreased markedly, but remained stable or increased in the neighboring territories. CFRs decreased markedly in Kazakhstan and marginally in Uzbekistan, and increased in the neighboring RF oblasts. From 1998 to 2004, DOTS appears to have helped avert approximately 17 800 deaths in Kazakhstan. CONCLUSION: DOTS has contributed markedly to a decrease in TB mortality in Kazakhstan. In settings where mortality data are relatively complete, deaths averted can be another indicator of DOTS effectiveness. |
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