Tuberculosis (TB) remains a significant problem worldwide. Bacille Calmette-Guérin (BCG) immunisation is used in many countries as part of their TB control programme. The efficacy of BCG immunisation in preventing TB in adults is unclear, but its efficacy in preventing serious extrapulmonary disease in infants is widely accepted.Selective neonatal BCG immunisation is one strategy used in New Zealand for controlling TB with the specific aim of reducing the risk of severe, disseminated disease in young children. The target groups were last reviewed in 2002 and a goal of 80% coverage by 2005 was set for high-risk infants. Dr Jillian Sherwood, a Public Health Medicine Registrar, conducted this review of neonatal BCG immunisation services in New Zealand in 2006 to describe the current BCG immunisation services and methods of delivery offered and to identify any imbalance between current policy and services
Purpose
This review, for the Communicable Diseases Team, evaluates the neonatal BCG immunisation service in New Zealand.
The review’s objectives were to:
- describe the neonatal BCG immunisation services offered and methods of delivery
- review the tuberculosis notification and hospitalisation data
- identify any imbalance between current policy and services
- review monitoring and make recommendations on the future monitoring of the service.
Methodology
A literature review of the relevant published and unpublished literature was undertaken using standard bibliographic databases, reputable standard text books, a manual search of archived material held by the Auckland Regional Public Health Service, and key websites.
Key informants were informally interviewed and all District Health Boards (DHBs) were surveyed about the components of their neonatal BCG service.
New Zealand notification and hospitalisation data for TB was extracted into MS Excel tables and reviewed to assess the relevance and effectiveness of the current policy and delivery of the service.