The Bacille Calmette–Guérin (BCG) vaccine has been shown to provide considerable protection against miliary or meningeal tuberculosis (TB), but whether it prevents other forms of disease remains controversial. Recent evidence has shown that the BCG vaccine also provides protection against latent TB infection (LTBI). The aim of the current study was to examine whether BCG has a protective role against LTBI among children in close contact with an adult index case in a low TB endemicity setting with the use of the QuantiFERON-TB Gold In-Tube test (QFT-GIT). A cross-sectional study was conducted over a 10-year period among children referred to our outpatient TB clinic with a history of close contact with an adult with pulmonary TB. All subjects had a QFT-GIT performed. In total, 207 children > 5 to 16 years of age with known recent exposure were enrolled. BCG-vaccinated subjects had a 59% lower risk of presenting with LTBI after close contact with an adult index case compared with unvaccinated subjects (OR = 0.41, 95% CI: 0.23–0.73, p = 0.002). After adjustment for possible confounders, the protective effect of prior BCG immunization was estimated at 68% (OR = 0.32, 95% CI: 0.15–0.66, p = 0.002). Other risk factors for LTBI included a history of migration (OR = 2.27, 95% CI: 1.13–4.53, p = 0.021) and transmission of infection to other exposed child contacts (OR = 4.62, 95% CI: 2.27–9.39, p = 0.001). We were able to determine a strong protective role of BCG vaccination among children older than 5 years, immunized at school entry, who had close contact with an adult infectious TB case.
1 February 2016 in European Journal of Emergency Medicine
Objective The European Paediatric Life Support (EPLS) provider course aims at training doctors and nurses in the efficient and prompt management of cardiopulmonary arrest in children. EPLS is a 2-day European Resuscitation Council course, involving the teaching of theoretical knowledge and practical skills. The aim of the study was to evaluate the retention of theoretical knowledge and certain skills of EPLS providers 4 months after the course. Materials and methods In total, 80 doctors and nurses who attended three EPLS provider courses, from May 2012 to December 2012, were asked to participate in the study and only 50 responded positively. Demographic data (age, sex, occupation) of the participants were collected. The European Resuscitation Council-approved EPLS written test was used to assess theoretical knowledge right after the course and after 4 months. The retention of certain skills (airway opening, bag-mask ventilation, chest compressions) was also examined. Results The theoretical knowledge decreased significantly (P<0.001) 4 months after the course. Age, sex and occupational status (medical or nursing profession) had no effect in theoretical knowledge retention. Interestingly, certain skills such as the application of airway opening manoeuvres and effective bag-mask ventilation were retained 4 months after the course, whereas chest compression skill retention significantly declined (P=0.012). Conclusion According to our findings, theoretical knowledge of the EPLS course uniformly declines, irrespective of the provider characteristics, whereas retention of certain skills is evident 4 months after the course.
Skin disorders are one of the commonest causes of children’s referral to the emergency department and include changes in skin structure and appearance due to allergic reaction, infection, trauma or systemic disease. Skin infection can also be attributed to viral, bacterial, fungal or parasitic pathogens and varying lesions might often lead to diagnostic overshadowing. Herein, we report an interesting case of a young infant with a bug bite that was later infected by Staphylococcus aureus and rapidly progressed to eczema herpeticum despite no prior history of known atopic dermatitis. Challenges in diagnosis and investigations will be analyzed.
Skin disorders are one of the commonest causes of children’s referral at the emergency department and include changes in skin structure and appearance due to allergic reaction, infection, trauma or systemic disease. Skin infection might be attributed to viral, bacterial, fungal or parasitic pathogens and varying lesions might often mislead to diagnostic overshadowing. Herein, we report an interesting case of a young infant with a Staphylococcus aureus infected bug bite, progressing to eczema herpeticum with no prior history of known atopic dermatitis. Challenges in diagnosis and investigations will be analyzed.