{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T06:00:08Z","timestamp":1670047208063},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2022,4,23]],"date-time":"2022-04-23T00:00:00Z","timestamp":1650672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>One hundred years ago, Albert Calmette developed an avirulent strain of Mycobacterium bovis, but there is no evidence that his BCG strain was more immunogenic than wild-type M. bovis. Geographic variations in BCG efficacy remain ill-understood. We hypothesized that exposure to M. bovis through unpasteurized milk might protect against Mycobacterium tuberculosis and Mycobacterium leprae.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>After excluding high-income countries (with universal milk pasteurization) and microstates, an ecological study comprising 113 countries was conducted. National data were obtained from United Nations agencies and international organizations about milk production per capita (1980\u20131999) as a proxy for exposure to wild-type M. bovis, TB (2000\u20132019) and leprosy (2005\u20132019) incidence, HIV prevalence (2000\u20132019), human development index (2010), global hunger index (2010), neonatal BCG coverage (1980\u20131999), urbanization (2000) and temperature (1990\u20132020). Multiple linear regression analyses were performed using log-transformed variables.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>For TB, the association differed by region. An inverse association with milk production was seen in regions outside, but not within, sub-Saharan Africa, after adjustment for confounders. The incidence of leprosy was inversely associated with milk production when combining all countries, but the association was stronger in sub-Saharan Africa.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Exposure to wild-type M. bovis through unpasteurized milk may provide cross-protection against M. tuberculosis and M. leprae and contribute to geographic disparities in BCG efficacy. This needs to be confirmed by individual-level studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/trac032","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T20:13:00Z","timestamp":1647634380000},"page":"1112-1122","source":"Crossref","is-referenced-by-count":0,"title":["In the footsteps of Albert Calmette: an ecological study of TB, leprosy and potential exposure to wild-type <i>Mycobacterium bovis<\/i>"],"prefix":"10.1093","volume":"116","author":[{"given":"Jacques","family":"P\u00e9pin","sequence":"first","affiliation":[{"name":"Department of microbiology and infectious diseases , Universit\u00e9 de Sherbrooke, 3001 12i\u00e8me Avenue Nord, Sherbrooke, Qu\u00e9bec, J1H 5N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aicha","family":"Fox","sequence":"additional","affiliation":[{"name":"Department of microbiology and infectious diseases , Universit\u00e9 de Sherbrooke, 3001 12i\u00e8me Avenue Nord, Sherbrooke, Qu\u00e9bec, J1H 5N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louiselle","family":"LeBlanc","sequence":"additional","affiliation":[{"name":"Department of microbiology and infectious diseases , Universit\u00e9 de Sherbrooke, 3001 12i\u00e8me Avenue Nord, Sherbrooke, Qu\u00e9bec, J1H 5N4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"De Wals","sequence":"additional","affiliation":[{"name":"Department of social and preventive medicine , Universit\u00e9 Laval, 2725 chemin Ste-Foy, Qu\u00e9bec, Qu\u00e9bec, G1V 4G5, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Claude","family":"Rousseau","sequence":"additional","affiliation":[{"name":"Centre Armand-Frappier Sant\u00e9 Biotechnologie, Institut National de la Recherche Scientifique , 531 boulevard des Prairies, Laval, Qu\u00e9bec, H7V 1B7 Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,4,23]]},"reference":[{"key":"2022120214252278300_bib1","volume-title":"Albert Calmette et le BCG","author":"Kervran","year":"1962"},{"key":"2022120214252278300_bib2"},{"issue":"1","key":"2022120214252278300_bib3","doi-asserted-by":"crossref","first-page":"e2","DOI":"10.1016\/S1473-3099(21)00403-5","article-title":"100 years of Mycobacterium bovis bacille Calmette-Gu\u00e9rin","volume":"22","author":"Lange","year":"2022","journal-title":"Lancet Infect Dis"},{"key":"2022120214252278300_bib4","volume-title":"Tuberculose pulmonaire et localisations extra-pulmonaires","author":"Camino","year":"1924"},{"key":"2022120214252278300_bib5","volume-title":"La vaccination pr\u00e9ventive de la tuberculose par le BCG (Bacille de Calmette-Gu\u00e9rin)","author":"Calmette","year":"1928"},{"key":"2022120214252278300_bib6","first-page":"31","article-title":"Bovine tuberculosis in Africa","author":"Van Helden","year":"2019:","journal-title":"Tuberculosis in animals: an African perspective"},{"issue":"1-2","key":"2022120214252278300_bib7","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1054\/tube.2000.0263","article-title":"Mycobacterium bovis infection in human beings","volume":"81","author":"Grange","year":"2001","journal-title":"Tuberculosis"},{"key":"2022120214252278300_bib8","first-page":"0129926","article-title":"Longevity of Mycobacterium bovis in raw and traditional souring milk as a function of storage temperature and dose","author":"Michel","year":"2015","journal-title":"PLoS One"},{"issue":"13","key":"2022120214252278300_bib9","doi-asserted-by":"crossref","first-page":"7877","DOI":"10.1073\/pnas.1130426100","article-title":"The complete genome sequence of Mycobacterium bovis","volume":"100","author":"Garnier","year":"2003","journal-title":"Proc Natl Acad Sci USA."},{"key":"2022120214252278300_bib10","article-title":"World Bank countries and lending groups. 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