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The problem
Intervention: BCG (Bacille Calmette-Guérin) vaccination
Who it was tested with: Children and adolescents aged 0-19 years in Brazilian municipalities.
Experience from people who deliver programmes: stories, case studies and lessons learned. Valuable for understanding how and why, and for spotting what to test next, but not a measure of effect.
"We conducted an ecological study using national Brazilian administrative databases... The association between municipal BCG coverage and EPTB notification rates was examined using municipality-year negative binomial models with an offset for the population aged 0-19 years." This is a quasi-experimental ecological design using administrative data with adjustment for multiple confounders and sensitivity analyses across multiple years and spatial locations.
Ecological design prevents individual-level causal inference. Association estimates were substantially shifted toward the null when diagnostic infrastructure was included, suggesting confounding by healthcare system capacity rather than pure vaccination effect.
Across countries and designs
3 studies · 3 countries
