Browsing by Author "Caldwell, J"

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    BCG vaccination in South African HIV-exposed infants - risks and benefits
    (2009) Hesseling, A C; Caldwell, J; Cotton, M F; Eley, B S; Jaspan, H B; Jennings, K; Marais, B J; Nuttall, J; Rabie, H; Roux, P; Schaaf, H S
    Until 2007, the World Health Organization (WHO) recommended that bacille Calmette-Guérin (BCG) vaccination should be contraindicated in infants with symptomatic HIV disease in countries with a high burden of tuberculosis. This recommendation was based on the perceived low risk of serious adverse events in HIV-infected infants. The WHO revised its recommendations regarding BCG vaccination in HIV-infected infants in 2007, making HIV infection a full contraindication to BCG vaccination. BCG induces protective efficacy against tuberculous meningitis of 73% (67 - 79%) and against miliary disease of 77% (58 - 87%) in HIV-uninfected children. The efficacy against childhood pulmonary disease is variable;3 there is no evidence that BCG induces a protective effect against tuberculosis in HIV-infected infants and children. BCG is a safe vaccine in immunocompetent infants, and severe vaccine adverse events in HIV-uninfected infants occur only with rare primary immune deficiencies in approximately 1 per million vaccinees.
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    Community health care workers in South Africa are at increased risk for tuberculosis
    (2010) Kranzer, Kathar; Bekker, Linda-Gail; van Schaik, N; Thebus, L; Dawson, M; Caldwell, J; Hausler, H; Grant, R; Wood, R
    Many sub-Saharan African countries face a severe shortage of qualified HCWs as a result of the dual HIV/TB epidemic, which has triggered task shifting to a range of lay community health care workers (CHWs) – for example, home-based care workers, lay counsellors and adherence supporters, for both TB and highly active antiretroviral therapy (HAART). CHWs may experience a considerable occupational TB risk; however, their risk of TB disease and HIV prevalence has never been documented.