Ссылки на публикации последних лет, в которых с разной степенью убедительности доказывается, что вакцинация БЦЖ эффективна не только в противотуберкулёзной защите, но и в преодалении физиологической неонатальной иммунодепрессии:
Aronson NE, Santosham M, Comstock GW, Howard RS, Moulton LH, Rhoades ER, Harrison LH. - Long-term efficacy of BCG vaccine in American Indians and Alaska Natives: A 60-year follow-up study. - JAMA. 2004 May 5;291(17):2086-91.
Kumar R, Dwivedi A, Kumar P and Kohli N - Tuberculous meningitis in BCG vaccinated and unvaccinated children - J. Neurol. Neurosurg. Psychiatry 2005;76;1550-1554 [[Ссылки доступны только зарегистрированным пользователям ]
Soysal A, Millington KA, Bakir M, Dosanjh D, Aslan Y, Deeks JJ, Efe S, Stavele y I, Ewer K, Lalvani A. - Effect of BCG vaccination on risk of Mycobacterium tuberculosis infection in children with household tuberculosis contact: a prospective community-based study. - Lancet. 2005;366(9495):1443-51.
Briassoulis G, Karabatsou I, Gogoglou V, Tsorva A - BCG vaccination at three different age groups: response and effectiveness - Journal of Immune Based Therapies and Vaccines 2005,3:1[[Ссылки доступны только зарегистрированным пользователям ]
Carcillo J.A. - Reducing the global burden of sepsis in infants and children: A clinical practice research agenda - Pediatric Critical Care Medicine (2005) 6:3 SUPPL. (S157-S164)
Objective: Sepsis remains a predominant cause of mortality and morbidity in children in the developing and industrialized world. This review discusses a clinical practice research agenda to reduce this global burden. Design: Summary of the literature with analysis by experts. Results: Many interventions have been proven effective in decreasing sepsis. Heterologous
immunization with attenuated Bacillus Camille Guerin vaccine reduces all-cause mortality, and specific immunizations further reduce morbidity and mortality from many specific microbes. Antepartum antibiotics reduce the prevalence of cerebral palsy and mortality in infants. Administration of antibiotics to neonates with signs of sepsis reduces all-cause mortality
five-fold and can also reduce mortality in the big four killers of children: severe pneumonia, diarrhea, malaria, or measles. Immunonutrition with zinc and vitamin A can further reduce morbidity in diarrhea and pneumonia and reduce mortality in measles. First-hour rapid intravenous fluid resuscitation achieves 100% survival in dengue shock, and time-sensitive fluid resuscitation and inotropic support reduces mortality ten-fold in meningococcal septic shock. Multiple organ failure occurs when late or inadequate resuscitation results in systemic thrombosis or when infection is not eradicated because of immunosuppression or inadequate
source control. Conclusions: The global burden of sepsis can be reduced by 1) prevention with improved heterologous or specific vaccines and vitamin or mineral supplement programs; 2) early recognition and treatment with appropriate antibiotics, intravenous fluid resuscitation, and inotropic support in organized healthcare-delivery systems; and 3) development of new diagnostics and therapeutics that reduce systemic thrombosis, improve immune function, and kill resistant organisms.
Lehmann D., Vail J., Firth M.J., de Klerk N.H., Alpers M.P. - Benefits of routine immunizations on childhood survival in Tari, Southern Highlands Province, Papua New Guinea
International Journal of Epidemiology (2005) 34:1 (138-148).
Background: Non-specific beneficial as well as deleterious effects of childhood immunizations have been reported in areas of high mortality. This study aimed to determine the effects of diphtheria-tetanus-whole-cell-pertussis (DTP), BCG, hepatitis B, and measles vaccines on mortality in the highlands of Papua New Guinea (PNG). Methods: Demographic events for children born in 1989-1994 who were under monthly demographic surveillance in Tari were recorded from birth until age 2 years, out-migration, death, or the end of the study period. Data on BCG, hepatitis B, DTP, measles and pneumococcal polysaccharide vaccination were collected monthly from clinic records. To allow for different characteristics of immunized and non-immunized children, analysis included conditioning on a propensity score for vaccination, adjusting for differences in children's background characteristics. Results: In all, 101/3502 children (3%) who had at least one vaccine died between ages 29 days and 24 months were compared to 112/546 (21%) who had none. BCG was associated with lower mortality in the 1-5 month age group (hazard ratio [HR] = 0.17, 95% CI: 0.09, 0.34), measles vaccine with lower mortality at age 6-11 months (HR = 0.42, 95% CI: 0.17, 1.01), and pneumococcal polysaccharide vaccine with lower mortality at age 12-23 months (HR = 0.42, 95% CI: 0.19, 0.93). One or more doses of DTP was associated with lower overall mortality (HR = 0.27, 95% CI: 0.16, 0.44), particularly in the 1-5 month age group (HR = 0.19, 95% CI: 0.10, 0.34), and also in those who had had prior BCG (HR = 0.45, 95% CI: 0.22, 0.91). Conclusion: Routine immunizations are effective in reducing overall mortality in young children in an area of high mortality. In particular, DTP, whether considered separately or in addition to BCG, was associated with a lowering of overall mortality, in contrast to findings reported from Guinea-Bissau. (copyright)