BCG scar, socioeconomic and nutritional status: a study of newborns in urban area of Makassar, Indonesia

• Published in: Tropical medicine & international health 2019-06, Vol.24 (6), p.736-746
• Main Authors: Amaruddin, Aldian Irma, Wahyuni, Sitti, Hamid, Firdaus, Chalid, Maisuri T., Yazdanbakhsh, Maria, Sartono, Erliyani
• Format: Article
• Language: English
• Subjects: Adiponectin; Adipose tissue; Age; Bacille Calmette–Guérin scar; Bacillus Calmette-Guerin vaccine; BCG; Birth weight; Childbirth & labor; cicatrice du BCG; Exposure; Gestational age; Hepatitis; Hepatitis A; Immunization; Immunoglobulin G; Infants; Infections; Intestine; Leptin; leptine; Mathematical models; Neonates; Newborn babies; newborns; nouveau‐nés; Nutritional status; Original; Original Research Papers; Prenatal experience; Prenatal exposure; Protozoa; Socioeconomic factors; socioeconomic status; Socioeconomics; Statistical analysis; Statistical models; statut socioéconomique; Toxoplasma; Urban areas; Urban environments; Vaccination; Viruses; Weight
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.13232

Summary Objective To investigate factors that determine the response to Bacille Calmette–Guérin (BCG) vaccination in urban environments with respect to socioeconomic status (SES), prenatal exposure to infections or newborn's nutritional status. Methods The study was conducted in an urban area, in Makassar, Indonesia. At baseline, 100 mother and newborns pair from high and low SES communities were included. Intestinal protozoa, soil transmitted helminths, total IgE, anti‐Hepatitis A Virus IgG and anti‐Toxoplasma IgG were measured to determine exposure to infections. Information on gestational age, birth weight/height and delivery status were collected. Weight‐for‐length z‐score, a proxy for newborns adiposity, was calculated. Leptin and adiponectin from cord sera were also measured. At 10 months of age, BCG scar size was measured from 59 infants. Statistical modelling was performed using multiple linear regression. Results Both SES and birth nutritional status shape the response towards BCG vaccination at 10 months of age. Infants born to low SES families have smaller BCG scar size compared to infants born from high SES families and total IgE contributed to the reduced scar size. On the other hand, infants born with better nutritional status were found to have bigger BCG scar size but this association was abolished by leptin levels at birth. Conclusion This study provides new insights into the importance of SES and leptin levels at birth on the development of BCG scar in 10 months old infants. Objectif Investiguer les facteurs qui déterminent la réponse à la vaccination par le BCG en milieu urbain en ce qui concerne le statut socioéconomique (SSE), l'exposition prénatale aux infections ou l’état nutritionnel du nouveau‐né. Méthodes L’étude a été menée dans une zone urbaine, à Makassar, en Indonésie. Au départ, 100 paires mère‐nouveau‐né issues de communautés à statut social élevé et faible ont été incluses. Les protozoaires intestinaux, les helminthes transmis par le sol, les IgE totales, les IgG anti‐virus de l'hépatite A et anti‐ Toxoplasma ont été mesurés pour déterminer l'exposition aux infections. Des informations sur l’âge gestationnel, le poids/taille à la naissance et l’état d'accouchement ont été collectées. Le z‐score poids‐pour la taille, un indicateur indirect de l'adiposité du nouveau‐né a été calculé. La leptine et l'adiponectine provenant de sérum des cordons ont également été mesurées. A l’âge de 10 mois, la taille des cicatrices de BCG a ét