tuberculosis vaccine

Bacillus Calmette-Guerin in controlling type 1 diabetes: A quasi-experimental randomized clinical trial.

Ordoei Mahtab M, Behniafard Nasrin N, Namiranian Nasim N, Asadollahi Samira S et al.

T1DM is an autoimmune and chronic metabolic disorder characterized by the destruction of pancreatic beta cells. The Bacillus Calmette--Guérin (BCG) vaccine, originally used for tuberculosis prevention, has shown potential in modulating the immune response and improving beta-cell function. This study aimed to evaluate the therapeutic effects of two doses of BCG vaccine, administered four weeks apart, on glycemic control and selected immunological markers in patients with T1DM. In this single-center, double-blind randomized clinical trial, 33 patients with T1DM were enrolled and randomly assigned to intervention and control groups in a 1:1 ratio, matched by age and sex. The intervention group received two intradermal doses of the BCG vaccine, with a four-week interval. Fasting blood samples were collected at baseline and during follow-up to assess biochemical and immunological parameters. Patients were followed-up for 18 months. IRCT identifier: IRCT20201012049003N1; (date of registration: 2020/10/15). The mean age of participants was 11.25±3.32 years in the control group and 10.69±3.22 years in the BCG group. Anti-ICA levels significantly decreased in the BCG group by the end of the follow-up period. Although there was no significant difference in fasting blood glucose levels between the two groups, a significant reduction in HbA1c was observed in the BCG group after 18 months. The findings suggest that BCG vaccination may contribute to improved long-term glycemic control, as evidenced by reduced HbA1c levels, in patients with T1DM. Additionally, the decrease in Anti-ICA levels indicates a potential immunomodulatory effect, supporting the therapeutic promise of BCG in autoimmune diabetes.

COVID-19 Vaccine Knowledge, Practice, and Attitudes Among Hemodialysis Patients in Egypt, Kenya, and Cameroon: A Multicenter Study.

Elsayed Enass E, Kotb Khaled M KM, Heiba Ahmed A, Elhussini Manal Shaker MS et al.

Patients receiving hemodialysis (HD) are at increased risk of severe coronavirus disease 2019 (COVID-19) and were prioritized for vaccination, yet vaccine hesitancy remains common. We assessed COVID-19 vaccine knowledge, acceptance, and attitudes among patients receiving HD in Egypt, Kenya, and Cameroon and identified factors associated with vaccine acceptance, prior infection, willingness to receive future doses, and postvaccination complications. Multicenter cross-sectional survey study. Between March 2021 and April 2022, 765 patients receiving maintenance HD and 196 non-dialysis controls were recruited from dialysis centers in Egypt, Kenya, and Cameroon. Sociodemographic characteristics, clinical comorbidities, prior COVID-19, sources of vaccine information, and exposure to vaccinated or infected relatives. COVID-19 vaccine acceptance, willingness to receive future doses, prior infection, and post-vaccination complications. Structured questionnaires assessed knowledge, practices, and attitudes toward COVID-19 vaccination. Multivariable logistic regression identified factors independently associated with study outcomes. Vaccine acceptance was lower among patients receiving HD than nondialysis controls (58.2% vs 96.2%). Fear of side effects was the most common reason for refusal (39.3%). Postvaccination complications were less frequent among patients receiving HD (22.3% vs 44.3%). Hesitancy was more common among women, younger participants, and those with comorbidities or no prior COVID-19. Having vaccinated or previously infected relatives was associated with a greater willingness to receive future doses. Cross-sectional design limits causal inference. Nonprobability sampling and unmatched controls may limit generalizability. COVID-19 cases may have been underreported because of limited testing. COVID-19 vaccine hesitancy among patients receiving HD is driven by fear, misinformation, and sociodemographic factors. Targeted education and improved access to reliable vaccine information may help increase uptake in this population.

Social determinants of abdominal tuberculosis severity: An experience from a large tertiary care center.

Samad Abdul A, Akbar Ali A, Butt Nazish N, Idris Omar O

Abdominal tuberculosis is a concern in developing countries due to socioeconomic factors, influencing disease severity. This study at Jinnah Postgraduate Medical Centre (JPMC), Karachi, aimed to explore the link between social determinants like socioeconomic status, residence, co-morbidities, addiction patterns, and abdominal tuberculosis severity in patients. A descriptive cross-sectional study was conducted at the Department of Gastroenterology, JPMC, Karachi. Study duration was 16 months from September 26, 2024 to January 26, 2026. A total of 503 patients diagnosed with intestinal tuberculosis were included. Data on social determinants such as socioeconomic status, residence, addiction, HIV status, diabetes, and malnutrition were collected. Disease severity was categorized as mild, moderate or severe based on clinical and radiological, endoscopic assessment. Associations between social determinants and abdominal tuberculosis severity were analyzed using Chi-square tests with a significance level of p ≤ 0.05. The sample was nearly evenly split by gender and had a mean age of 47.7 years. Most participants came from urban areas and low to middle socio-economic backgrounds. Notably, 20.3% were HIV-positive, 4.2% had diabetes, and nearly one-third (32.7%) were malnourished. Addictive behaviors were common, with 27.8% chewing tobacco and 15% smoking. The severity of intestinal TB was classified as mild (39.9%), moderate (30.7%), or severe (29.4%), based on predefined criteria. While gender, socio-economic status, residence, and HIV status were not significantly associated with disease severity, diabetes (p = 0.029), malnutrition (p = 0.001), type of addiction (p = 0.001), and geographic location (p = 0.001) showed significant correlations. Abdominal tuberculosis severity is significantly influenced by factors like diabetes, malnutrition, type of addiction, and geographic location but not with socioeconomic status, gender, and residence.

Embracing Tuberculosis Preventive Treatment: A Crucial Step towards TB Control in Pakistan.

Basit Anila A, Hamayun Zille Z