{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T06:27:00Z","timestamp":1769149620595,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,10,22]],"date-time":"2015-10-22T00:00:00Z","timestamp":1445472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2015,12]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>To test the hypothesis that having a scar and a positive tuberculin skin test (TST<\/jats:styled-content>) response after vaccination with B<\/jats:styled-content>acille C<\/jats:styled-content>almette\u2013G<\/jats:styled-content>u\u00e9rin (BCG<\/jats:styled-content>) is associated with reduced infant mortality.<\/jats:p><\/jats:sec>Methods<\/jats:title>We studied cohorts of 2709 normal\u2010birthweight (NBW<\/jats:styled-content>) and 1102 low\u2010birthweight (LBW<\/jats:styled-content>) infants in Guinea\u2010Bissau. Children were enrolled in randomised trials between year 2002 and 2008 and received BCG<\/jats:styled-content> vaccination at birth. BCG<\/jats:styled-content> scars and TST<\/jats:styled-content> responses were assessed at 2 and 6 months of age. The infants were followed for mortality to 12 months of age, and survival was analysed using Cox regression.<\/jats:p><\/jats:sec>Results<\/jats:title>At age 2 months, 88% of NBW<\/jats:styled-content> children and 91% of LBW<\/jats:styled-content> children had a BCG<\/jats:styled-content> scar, and 36% and 17% had a TST<\/jats:styled-content> response, respectively. The LBW<\/jats:styled-content> infants had nearly twofold higher mortality (4.5%) than the NBW<\/jats:styled-content> infants (2.8%) between 2 and 12 months of age. In the LBW<\/jats:styled-content> cohort, the adjusted mortality rate ratio (MRR<\/jats:styled-content>) comparing children with a BCG<\/jats:styled-content> scar with those without was 0.42 (95% CI<\/jats:styled-content> = 0.19; 0.93). There was a similar tendency for TST<\/jats:styled-content> positivity: MRR<\/jats:styled-content> = 0.47 (95% CI<\/jats:styled-content> = 0.14; 1.54). For LBW<\/jats:styled-content> children who had both a positive TST<\/jats:styled-content> reaction and a scar, the MRR<\/jats:styled-content> was 0.22 (95% CI<\/jats:styled-content> = 0.05; 0.87). For NBW<\/jats:styled-content> children, a scar and a positive TST<\/jats:styled-content> were associated with 20% reductions in mortality, which did not reach statistical significance.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>We confirmed previous observations that having a scar and a TST<\/jats:styled-content> response after BCG<\/jats:styled-content> vaccination is associated with lower mortality risk. The possibility of revaccinating scar\u2010negative children should be considered.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12614","type":"journal-article","created":{"date-parts":[[2015,10,1]],"date-time":"2015-10-01T21:44:41Z","timestamp":1443735881000},"page":"1733-1744","source":"Crossref","is-referenced-by-count":25,"title":["Tuberculin reaction and BCG<\/scp> scar: association with infant mortality"],"prefix":"10.1111","volume":"20","author":[{"given":"Clara Amalie Gade","family":"Timmermann","sequence":"first","affiliation":[{"name":"Department of Environmental Medicine Institute of Public Health University of Southern Denmark Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofie","family":"Biering\u2010S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Research Centre for Vitamins and Vaccines Bandim Health Project Bissau Guinea\u2010Bissau"},{"name":"Bandim Health Project INDEPTH Network Bissau 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Vitamins and Vaccines Bandim Health Project Bissau Guinea\u2010Bissau"},{"name":"Bandim Health Project INDEPTH Network Bissau Guinea\u2010Bissau"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine Stabell","family":"Benn","sequence":"additional","affiliation":[{"name":"Research Centre for Vitamins and Vaccines Bandim Health Project Bissau Guinea\u2010Bissau"},{"name":"OPEN Institute of Clinical Research University of Southern Denmark\/Odense University Hospital Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Ravn","sequence":"additional","affiliation":[{"name":"Research Centre for Vitamins and Vaccines Bandim Health Project Bissau Guinea\u2010Bissau"},{"name":"OPEN Institute of Clinical Research University of Southern Denmark\/Odense University Hospital Odense 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