Internship POI BCG, The Hague, the Netherlands

Systematic review and meta-analysis of protection by BCG vaccination against Mycobacterium tuberculosis infection  

Research question

Does BCG vaccination protect against Mycobacterium tuberculosis infection?

Scientific background

Protection against infection by the Bacille Calmette-Guérin (BCG) vaccine against Mycobacterium tuberculosis remains a subject of controversy. While BCG was previously thought to protect mainly against disease, several studies have indicated that BCG might in addition provide protection against TB infection.4 However, since infection with M. tuberculosis cannot be measured with certainty, this remains controversial. A meta-analysis of a small number of observational studies among children by Roy et al found a reduced risk for interferon-gamma release assay (IGRA) conversion among BCG-vaccinated compared to non-vaccinated children.5 The BCG protective efficacy against infection was 27% (risk ratio 0.73, 95% confidence interval [CI] 0.61–0.87), but sub-analyses showed protection against infection only in countries at latitudes more than 40 degrees from the equator.5

With approximately 14 new TB vaccine candidates in the pipeline, there is a need to update the systematic review and meta-analysis conducted by Roy et al in 2014. Therefore, we will examine the evidence for the protective effect of BCG against M. tuberculosis infection by conducting a systematic review and meta-analysis.  We will consider stratification of the results by variables such as latitude, the recommended age for vaccination in the research’s region, diagnostic essay, and study quality that might affect the measured protective effect of BCG. In addition we will investigate how many of the studies also collected information on TB disease development

Research design

Systematic review and Meta-analysis

Methods

Setting

LMIC

Data collection

Search all relevant literature libraries Pubmed, Embase,  Medline and the Cochrane Library as well as grey literature by applying relevant search terms following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Screen titles and abstracts from the search results and identify studies for assessment.

Requirement

  • The intern must be affiliated/enrolled in an education program, of which this internship should be part.
  • The intern should be available minimum 4 days per week
  • The intern should be based in the Netherlands

 Time schedule

February- June 2023 (flexible)

Supervision

This project is a collaboration between KNCV, AIGHD and LSHTM. The intern will receive daily supervision from Puck Pelzer (epidemiologist at KNCV) and bi-weekly supervision from dr. Logan Stuck (statistician at AIGHD)

Medical ethics committee

Necessary (exemption of) approval from relevant medical ethics committees is already obtained, as this internship is part of an ongoing project.

Expected result

  • MSc thesis
  • Presentation in English for the university and internally in the organization
  • Draft manuscript for scientific publication

Application and information

Does this opportunity interest you? If so please reach out to the scientific lead – Puck Pelzer (puck.pelzer@kncvtbc.org) with your CV and motivation letter.

KNCV has been fighting TB since its establishment in 1903. Over the past 117 years, the organization has acquired indispensable knowledge and experience in the field of effective TB control, resulting in pre-elimination in the Netherlands and significant contributions to global evidence generation, policy development and TB program implementation worldwide.

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