A medical student asks why BCG is still given at birth in India despite its limited efficacy against pulmonary tuberculosis. Against which forms does BCG confer its strongest documented protection?

• A Adult sputum-positive pulmonary tuberculosis
• B Latent tuberculosis infection reactivation in adolescents
• C Disseminated (miliary) tuberculosis and tuberculous meningitis in children ✓
• D Lymph node tuberculosis in adults

Explanation

BCG protects children against the severe disseminated forms of tuberculosis, namely miliary tuberculosis and tuberculous meningitis, which justifies its continued use at birth. Its efficacy against adult sputum-positive pulmonary disease is variable and generally poor, which is exactly why it does not interrupt transmission. Reactivation of latent infection and adult lymph node disease are not protected outcomes attributable to neonatal BCG.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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