scholarly journals Association Between BCG Policy is Significantly Confounded by Age and is Unlikely to Alter Infection or Mortality Rates

2020 ◽  
Author(s):  
Stefan Kirov
Keyword(s):  
Mortality Rates ◽  
Causal Link ◽  
Confounding Factors ◽  
Income Levels ◽  
Bcg Vaccination ◽  
Start Date ◽  
The Press ◽  
Number Of Publications ◽  
Public Policy Decisions ◽  
Mandatory Vaccination

AbstractRecently a number of publications looked at the association between COVID-19 morbidity and mortality on one hand and countries’ policies with respect to BCG vaccination on the other. This connection arises from differences in the rates of infection in countries where BCG vaccination is mandatory compared to countries where mandatory vaccination no longer exists or was never implemented in the first place. In at least 2 preprint publications the authors expressed the view that the “known immunological benefits” of BCG vaccination may be behind the biological mechanism of such observation.One study accounted for different income levels in different groups. Another study did not attempted to do so, instead exploring the differences between countries where a booster shot is given vs others where no such practice exists (finding no connection).Both of these studies did not explore other potential confounding factors. Meanwhile the press has focused on these headlines and pushed the narrative that BCG vaccination is causally linked to infection and mortality rates. This poses a serious challenge, demonstrated by the recently initiated clinical trials on BCG vaccination within the COVID19 context.This study shows that population age is a very significant confounding factor that explains the rates of infections much better and has a solid biology mechanism which explains this correlation. It suggests that BCG vaccination may have little or no causal link to infection rates and advises that any follow up studies should control for several confounding factors, such as population age, ethnicity, rates of certain chronic diseases, time from community spread start date, major public policy decisions and income levels.

scholarly journals Relationship between Bacillus Calmette Guerin Vaccination Policy and Coronavirus Disease-2019 (COVID-19) Incidence

2021 ◽  
Author(s):  
Soheila Alyasin ◽  
Zahra Kanannejad ◽  
Hossein Esmaeilzadeh ◽  
Hesamedin Nabavizadeh ◽  
Mohammad Amin Ghatee ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Large Scale ◽  
Mortality Rates ◽  
Epidemiological Studies ◽  
Bcg Vaccine ◽  
Confounding Factors ◽  
Protective Effects ◽  
Bacillus Calmette Guerin ◽  
Vaccination Policy ◽  
Bcg Vaccination

Bacillus Calmette Guerin (BCG) was designed for protecting children against tuberculosis. Also, it can protect against other infectious diseases through the induction of trained immunity. Due to its heterologous protective effects, the BCG vaccine has been proposed as a treatment option for coronavirus disease-2019 (COVID-19). Epidemiological studies have found that countries without BCG vaccination policy have experienced higher mortality rates related to COVID-19 infection than those with BCG vaccination policy. However, there are some confounding factors such as age, population intensity, immigration, the pandemic phase, and data accuracy that may affect these results. Therefore, this hypothesis should be evaluated by clinical trial studies. Large-scale clinical trials are in progress to investigate if the BCG vaccine could be used as a useful tool for protection against COVID-19 infection.

FREQUENCY RATE OF BCG VACCINATION AND SELECTED INDICATORS OF CLINICAL CHARACTERISTICS OF TUBERCULOSIS IN SCHOOL-AGE CHILDREN

2021 ◽  
Vol 100 (5) ◽  
pp. 124-130
Author(s):  
V.A. Aksenova ◽  
◽  
A.V. Gordina ◽  
S.A. Sterlikov ◽  
D.A. Kucheryawaya ◽  
...  
Keyword(s):  
Repeated Administration ◽  
Bcg Vaccine ◽  
School Age Children ◽  
Confounding Factors ◽  
Bcg Vaccination ◽  
Data Registration ◽  
Comparison Groups ◽  
The Russian Federation ◽  
Group 2 ◽  
Group 1

Objective of the study: to assess the effect of the frequency of administration of the BCG vaccine on the nature and structure of clinical forms of tuberculosis (TB) in children. Materials and methods of research: a cohort observational retrospective continuous comparative multicenter crosssectional study was carried out. The data (registration form № 089/u-tube) of 3253 children of 7–14 years old with newly revealed changes in the lungs of a specific genesis, registered in 2019–2020 in the institutions of the anti-tuberculosis service of the Russian Federation were analyzed. Two comparison groups were identified: group 1 (observation group) – children who received a double injection of BCG vaccine (vaccination and revaccination) (n=184), group 2 (comparison group) – children who received a single BCG vaccination (n=3358). To achieve this goal, 5 null hypotheses were identified for testing which groups are formed from the received data array with the necessary parameters. The data were analyzed using univariate and multivariate analyzes (including confounding factors). Results: it was found that BCG revaccination does not reduce the risk of TB compared with residual changes after, it does not reduce the proportion of generalized forms of TB compared with localized forms (OR=2,4, p=0,08). The frequency of vaccination has not a statistically significant effect on the frequency of bacterial excretion (aOR=1,6, p=0,15) and destruction of lung tissue (OR=1,1, p=1). Revaccination has a statistically significant effect on the ratio of primary and secondary forms of TB, reducing the likelihood of its primary forms (aOR=0,4, p<0,001). In the course of multivariate analysis, it was found that the formation of primary or secondary TB, as well as the frequency of bacterial excretion in the comparison groups, was significantly influenced by confounding factors. Conclusion: this work has demonstrated the absence of a pronounced protective effect of repeated administration of the BCG vaccine on the clinical course of a specific process.

scholarly journals Preface

1974 ◽  
Vol 185 (1079) ◽  
pp. 125-126
Keyword(s):  
Industrial Effluents ◽  
Data Bank ◽  
Royal Commission ◽  
National Committee ◽  
Agricultural Chemicals ◽  
Technical Literature ◽  
The United Kingdom ◽  
The Press ◽  
Exhaust Fumes ◽  
Number Of Publications

In recent years much attention has been given to the hazards, actual and poten­tial, to man, wild life and the biosphere in general by the injection into the environment of ever-increasing quantities of man-made chemical substances. This is exemplified not only by increasing anxiety about pollution of air, land and waters by smoke and exhaust fumes, agricultural chemicals, oil, heavy metals and industrial effluents, of which specific incidents of gross pollution are reported in the press from time to time, but also by the very large number of publications on the subject now appearing in the scientific and technical literature. In the United Kingdom, the Royal Commission on Environmental Pollution is charged with the duty ‘to advise on matters. . . concerning the pollution of the environ­ment. . . and the future possibilities of danger to the environment’. In its second report the Royal Commission suggested the establishment of a ‘data bank’ on known correlations between chemical structure and environmental effect, no doubt with a view to anticipate ‘future possibilities of danger’. The views of the Royal Society on this suggestion were invited by the Chairman of the Royal Commission and on the recommendation of the British National Com­mittee for Problems of the Environment it was decided to hold a Discussion Meeting for the purpose of ventilating the idea of a data bank and also to promote an exchange of views about wider questions related to chemicals in the environment. The meeting took place on 27 April 1973; seven invited speakers presented contributions dealing with specific aspects, and each of their papers was dis­cussed from the floor. Their subject-matter is placed on record in the seven papers which follow, and we have appended a statement of the main conclusions reached as a result of the meeting. These conclusions have been endorsed by the National Committee and the Officers of the Society and transmitted to the Royal Commission.

Asthma and depressive and anxiety disorders among young persons in the community

2004 ◽  
Vol 34 (8) ◽  
pp. 1465-1474 ◽  
Author(s):  
RENEE D. GOODWIN ◽  
DAVID M. FERGUSSON ◽  
L. JOHN HORWOOD
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Anxiety Disorders ◽  
Fixed Effects ◽  
Childhood Adversity ◽  
Causal Link ◽  
Panic Attacks ◽  
Future Research ◽  
Confounding Factors ◽  
Co Morbidity

Background. The objectives of the study were to examine linkages between asthma and depressive and anxiety disorders in a birth cohort of over 1000 young persons studied to the age of 21 years. Specifically, the study aimed to ascertain the extent to which associations between asthma and depressive and anxiety disorders could be explained by non-observed fixed confounding factors.Method. Asthma and depressive and anxiety disorders were measured prospectively over the course of a 21-year longitudinal study. Fixed effects logistic regression models were used to determine the relationship between asthma and depressive and anxiety disorders, adjusting for potentially confounding factors.Results. Asthma in adolescence and young adulthood was associated with increased likelihood of major depression (OR 1·7, 95% CI 1·3–2·3), panic attacks (OR 1·9, 95% CI 1·3–2·8), and any anxiety disorder (OR 1·6, 95% CI 1·2–2·2). Associations between asthma and depressive and anxiety disorders were adjusted for confounding factors using a fixed effects regression model which showed that, after control for fixed confounding factors, asthma was no longer significantly related to major depression (OR 1·1), panic attacks (OR 1·1), or any anxiety disorder (OR 1·2). Additional post hoc analyses suggested that exposure to childhood adversity or unexamined familial factors may account for some of the co-morbidity of asthma and depressive and anxiety disorders.Conclusions. These results confirm and extend previous findings by documenting elevated rates of depressive and anxiety disorders among young adults with asthma, compared with their counterparts without asthma, in the community. The weight of the evidence from this study suggests that associations between asthma and depressive and anxiety symptoms may reflect effects of common factors associated with both asthma and depressive and anxiety disorders, rather than a direct causal link. Future research is needed to identify the specific factors underlying these associations.

scholarly journals „W krainę dziecka. Rzecz o uroku dziecięctwa” na materiałach ikonograficznych z II połowy XIX i początku XX wieku – wybrane problemy

2018 ◽  
pp. 317-343
Author(s):  
Monika Nawrot-Borowska
Keyword(s):  
20Th Century ◽  
Fairy Tales ◽  
Regional Scale ◽  
Cultural Changes ◽  
History Of Childhood ◽  
The Press ◽  
History Of ◽  
Life Education ◽  
Number Of Publications ◽  
Home And School

The present text is the second part of the author’s description of iconographic sources for studying the history of a child and childhood in the second half of 19th and the beginning of 20th century. In the former, the types of sources addressed to children were discussed, in which the researcher will find “pictures from the children’s world”. It showed examples of iconographic materials presenting children in various everyday and festal situations, published in the richly illustrated children’s press, fairy tales, stories, collections of literary pictures, poems, fettered speeches, illustrated primers and visual boards for the science of things. The subject of these findings is the child and childhood shown in iconographic materials in the second half of 19th and the beginning of 20th century. During this period, as a result of the ongoing civilizational, technological and cultural changes, a significant increase in the types and number of publications illustrated with graphics, and later also with photographs can be observed. The press is being developed, including the illustrated, women’s, family, socio-literary, everyday press, both on a general and regional scale. Also, numerous calendars are being published, including their illustrated versions. Daguerreotype is becoming popular while correspondence with the use of postcards is popularized. All these sources will be used as the source basis for the text, for the purpose of characterizing the iconographic materials depicting the children’s world. When analyzing the iconographic material in terms of history and pedagogy, the researcher of the history of childhood can find many interesting aspects. He or she can observe scenes from children’s lives, including family life, education (home and school education), relationships with adults and peers, undertaken pursuits, everyday activities, behaviors, ways of spending time, fun and pastimes. On their basis, the researcher can describe children’s appearance, dress, hairdo, toys, interiors, the surroundings in which they stayed and the equipment they used, which make up the material aspects of the children’s world. The particular types of iconographic sources will be presented below, where the researcher can find the scenes of childhood. In addition to discussing their specificity, the provided examples will illustrate the everyday life present in a given type of iconographic material.  

scholarly journals Benzodiazepines and risk of dementia: true association or reverse causation?

2013 ◽  
Vol 22 (4) ◽  
pp. 307-308 ◽  
Author(s):  
C. Barbui ◽  
C. Gastaldon ◽  
A. Cipriani
Keyword(s):  
Population Study ◽  
Current Practice ◽  
The Elderly ◽  
Causal Link ◽  
Confounding Factors ◽  
Reverse Causation ◽  
Increased Risk ◽  
Diagnosis Of Dementia ◽  
Benzodiazepine Use ◽  
True Association

According to a recently published population study conducted in France, exposure to benzodiazepines may be associated with an approximately 50% increase in the risk of dementia in the elderly. However, the clinical interpretation of this finding raised some concerns. A causal link between benzodiazepine use and diagnosis of dementia may be real, but it is nevertheless possible that the increased risk might be due to other confounding factors. In this article, the main strengths and weaknesses of this study are briefly analysed, including the possibility of reverse causation. Implications for research and current practice are discussed.

scholarly journals Global trends in adolescents’ road traffic injury mortality, 1990–2019

2021 ◽  
pp. archdischild-2020-319184
Author(s):  
Uzma Rahim Khan ◽  
Junaid A Razzak ◽  
Martin Gerdin Wärnberg
Keyword(s):  
Low Income ◽  
Road Traffic ◽  
Mortality Rates ◽  
Road Traffic Injury ◽  
Low Income Countries ◽  
Middle Income ◽  
Income Levels ◽  
Middle Income Countries ◽  
Traffic Injury ◽  
Road Users

ObjectiveThe aim of this study was to determine the trends of road traffic injury (RTI) mortality among adolescents aged 10–14 years and 15–19 years across different country income levels with respect to the type of road users from 1990 to 2019.MethodsWe conducted an ecological study. Adolescents’ mortality rates from RTIs at the level of high-income countries (HICs), upper-income to middle-income countries (UMICs), lower-income to middle-income countries and low-income countries were extracted from the Global Burden of Disease study. Time series were plotted to visualise the trends in mortality rates over the years. We also conducted Poisson regression using road traffic mortality rates as the dependent variable and year as the independent variable to model the trend of the change in the annual mean mortality rate, with incidence rate ratios (IRRs) and 95% CIs.ResultsThere were downward mortality trends in all types of road users and income levels among adolescents from 1990 to 2019. HICs had more pronounced reductions in mortality rates than countries of any other income level. For example, the reduction in pedestrians in HICs was IRR 0.94 (95% CI 0.90 to 0.98), while that in UMICs was IRR 0.97 (95% CI 0.95 to 0.99) in adolescents aged 10-14 years.ConclusionsThere are downward trends in RTI mortality in adolescents from 1990 to 2019 globally at all income levels for all types of road users. The decrease in mortality rates is small but a promising finding. However, prevention efforts should be continued as the burden is still high.

scholarly journals Income Levels and Mortality Rates in Patients with Chronic Kidney Disease in South Korea: a Population-Based Cohort Study Using National Health Insurance Data

2020 ◽  
Author(s):  
Young Choi
Keyword(s):  
Chronic Kidney Disease ◽  
Health Insurance ◽  
Kidney Disease ◽  
Mortality Rate ◽  
National Health Insurance ◽  
National Health ◽  
Mortality Rates ◽  
Dialysis Patients ◽  
Income Levels ◽  
Low Incomes

Background: To examine the association between income levels and mortality rates in patients with chronic kidney disease. Methods: We analyzed data obtained from 3,172 patients with chronic kidney disease obtained from the Korean National Health Insurance claims database (2003&ndash;2009). Each patient was monitored until December 2010 or until death, whichever came first. Individual income was estimated from the national health insurance premium. Information on mortality was obtained from the Korean National Statistical Office. Cox proportional hazard models were used to compare mortality rates between different income groups after adjusting for possible confounding risk factors. Results: A low income was significantly associated with a high mortality rate after adjusting for covariates (adjusted HR 1.298 [1.082&ndash;1.556]). In addition, dialysis patients who had low incomes were more likely to have higher mortality rates compared to those in dialysis patients who had high incomes (adjusted HR 1.528 [1.122&ndash;2.082]). Conclusion: The findings of this study indicate that chronic kidney disease patients with low incomes have the highest mortality risk. Promotion of targeted policies and priority health services for patients with low incomes may help reduce the mortality rate in this vulnerable group.

scholarly journals Association between COVID-19 morbidity and mortality rates and BCG vaccination policies in OECD countries

2020 ◽  
pp. 175717742097681
Author(s):  
Yuki Senoo ◽  
Yosuke Suzuki ◽  
Kenji Tsuda ◽  
Tetsuya Tanimoto ◽  
Kenzo Takahashi
Keyword(s):  
Protective Effect ◽  
Mortality Rates ◽  
Oecd Countries ◽  
Morbidity And Mortality ◽  
Bcg Vaccination

We compared whether the national BCG vaccination (BCGV) policy influenced coronavirus disease 2019 (COVID-19) in Organisation for Economic Co-operation and Development (OECD) countries. Those currently implementing BCGV have a reduced number of COVID-19 morbidity and mortality cases, compared to those who have never implemented a BCGV policy, suggesting the potential protective effect of BCGV against COVID-19.

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