A Study on the Effects of BCG Vaccination against Tuberculosis

BCG의 결핵예방(結核豫防) 효과에 관(關)한 연구(硏究)

In Korea BCG vaccination has been employed as the main control measure for tuberculosis since 1962. Recently, the protective efficacy of BCG against tuberculosis has been controversial worldwide. A case-control study was conducted to evaluate the efficacy of BCG in Korea which has a high prevalence of tuberculosis(2.5%). The study subjects were children under the age of 14 years who were hospitalized and diagnosed as tuberculosis in three general hospitals in Taegu City during last 6 years ($1975{\sim}1980$). Among 416 hospitalized tuberculous patients, 314 cases were confirmed as to the presence or absence of the BCG scar. A control group was selected from the same hospital patients of the same period as the cases. The control group was other than tuberculous patients whose distribution of age, sex and residence were the same as the cases. The results obtained are as follows: For all forms of tuberculosis, the relative risk and the protective efficacy of BCG were 3.5 and 71.8%. The efficacy was higher among female than among male (78.6% vs. 65.8%). The efficacy was higher among the one year and above than among less than 1 year of age. For tuberculous meningitis, the relative risk and the protective efficacy of BCG were 3.9 and 74.3 %. The efficacy was statistically significantly higher among female than among male (p<0.05). The relative risk and the protective efficacyt of BCG for uberculous meningitis combined with miliary tuberculosis and combined with pulmonary tuberculosis represented 6.9, 85.6%, and 7.4, 86.5%, respectively. On the other hand, the relative risk and the protective efficacy of BCG for miliary tuberculosis were 2.1 and 51.6%, and for pulmonary tuberculosis, 2.3 and 54.7%, respectively. From these results, it appears that BCG vaccination is an efficient preventive measure in Korea where tubercluosis is prevalent. Thus the routine BCG vaccination should be continued.

1975년(年)부터 1980년(年)까지 6년간(年間) 대구시내(大邱市內) 3개(個) 종합병원(綜合病院)에 입원(入院)되어 결핵(結核)으로 확진(確診)된 14세이하(歲以下) 환자(患者) 416중(中) BCG접종여부(接種與否)가 명확(明確)한 314명(名)을 대상(對象)으로 대조군(對照群)의 성별(性別), 년령별(年齡別) BCG접종율(接種率)을 기준(基準)삼아 BCG효과를 평가(評價)한 결과(結果) 그 성적(成績)을 요약(要約)하면 다음과 같다. 총(總) 314명(名)의 결핵환자(結核患者)에 대하여 BCG의 결핵방지효과를 평가(評價)한 결과(結果) BCG비접종군(非接種群)이 접종군(接種群)에 비하여 결핵(結核)에 걸릴 위험도(危險度)가 3.5배(倍)나 높았으며, BCG의 발병방지효과는 71.8%로 나타났다. 결핵성뇌막염(結核性腦膜炎)의 경우 BCG비접종군(非接種群)이 접종군(接種群)보다 비교위험도(比較危險度)가 3.9배(倍) 높으며, BCG효과면에서는 74.3%의 발병방지효과를 나타내었다. 여아군(女兒群)이 남아군(男兒群)에 비하여 BCG효과가 높음을 인정(認定)할 수 있었다(p<0.05). 조립결핵(粟粒結核)을 동반(同伴)한 결핵성뇌막염(結核性腦膜炎)의 경우 비교위험도(比較危驗度)는 6.9이었으며 BCG효과는 85.6%로 나타났다. 폐결핵(肺結核)을 동반(同伴)한 결핵성뇌막염(結核性腦膜炎)의 경우 비교위험도(比較危驗度)는 7.4이였으며 발병방지효과는 86.5%로 나타났고, 남아군(男兒群)이 여아군(女兒群)보다 그 효과가 현저(顯著)히 높았다(p<0.05). 조립결핵(粟粒結核)의 경우 비교위험도(比較危驗度)는 2.1이며 발병방지효과는 51.9%였으며, 폐결핵(肺結核)의 경우는 각각(各各) 2.2 및 54.7%로 나타났다. 폐결핵(肺結核)을 제외한 전결핵(全結核)의 경우 비교위험도(比較危驗度)는 4.1, BCG효과는 75.3%로 나타났으며,폐결핵(肺結核)에 비하여 결핵성뇌막염(結核性腦膜炎) 및 타결핵(他結核)을 동반(同伴)한 결핵성뇌막염(結核性腦膜炎)에서 발병방지효과가 현저(顯著)하게 높았다(p<0.05). 이상을 종합(綜合)하면 BCG효과에 부정적(否定的)인 역할(投割)을 할 여러가지 방해요인(妨害要因)이 있음에도 불구하고 질적(質的)으로 중증(重症)인 결핵성뇌막염(結核性腦膜炎)에서는 거의 80%의 예방력(豫防力), 조립결핵(粟粒結核) 및 폐결핵(肺結核)에서는 약 50%의 발병방지효과를 관찰(觀察)할 수 있었다. 따라서 결핵관리사업(結核管理事業)으로 BCG접종(接種)의 권장(勸奬)이 계속(繼續) 요망(要望)된다.