Systematic review and meta-analysis on BCG lymphadenitis incidence in healthy children
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Key Takeaway
Consider the pooled 2.5% incidence of BCG lymphadenitis in children, noting significant variability across studies.
This is a systematic review and meta-analysis of the incidence proportion of BCG lymphadenitis in healthy children. The authors synthesized data from studies involving about 1.8 million children. The pooled incidence proportion was 2.5% (95% CI, 1.6-3.6), with individual study results ranging from 0.0% to 25.6%.
The review found that incidence proportions were significantly higher with active surveillance compared to passive surveillance. Incidence was also significantly higher in randomized controlled trials versus prospective and retrospective cohort studies. Incidence significantly differed by study quality, publication period, and BCG strain.
The authors note substantial variability in the incidence of BCG lymphadenitis among diverse studies. They acknowledge the influence of surveillance methods, study design, and vaccine strain on reported outcomes as key limitations.
Practice relevance is not specified. The evidence is observational and does not establish causality. Clinicians should interpret these pooled estimates with caution due to the noted heterogeneity.
View Original Abstract ↓
Few systematic reviews or meta-analyses have addressed on the incidence of Bacille Calmette-Guérin (BCG) lymphadenitis in healthy children. A systematic literature search was independently conducted by two researchers using four English and Korean databases (PubMed, Scopus, KMbase, RISS). The risk of bias was assessed. A total of 52 peer-reviewed journal articles (about 1.8 million children) were included in meta-analyses. The incidence proportion of BCG lymphadenitis ranged from 0.0% to 25.6%. The pooled incidence proportion was 2.5% (95% CI, 1.6-3.6; I = 99%). Studies employing active (vs. passive) surveillance reported a significantly higher incidence proportion of lymphadenitis, as did randomized controlled trials (vs. prospective and retrospective cohort studies). Also, the incidence significantly differed according to study quality, publication period, and BCG strain. This study highlights substantial variability in the incidence of BCG lymphadenitis among diverse studies and underscores the influence of surveillance methods, study design, and vaccine strain on reported outcomes.
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