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BCG scar, socioeconomic and nutritional status: a study of newborns in urban area of Makassar, Indonesia
Author(s) -
Amaruddin Aldian Irma,
Wahyuni Sitti,
Hamid Firdaus,
Chalid Maisuri T.,
Yazdanbakhsh Maria,
Sartono Erliyani
Publication year - 2019
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13232
Subject(s) - medicine , gestational age , socioeconomic status , vaccination , malnutrition , birth weight , low birth weight , pregnancy , population , pediatrics , demography , immunology , environmental health , biology , sociology , genetics
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.