A case-control study of protection against tuberculosis by BCG revaccination in Recife, Brazil.

SETTING: Metropolitan region of Recife, Brazil. OBJECTIVE: To estimate the additional protection against tuberculosis (TB) provided by a second dose of bacille Calmette-Guérin (BCG) vaccine. DESIGN: Case-control study. Cases were cases of TB newly diagnosed by the TB control programme, independent of clinical form. Three matched neighbourhood controls were selected using a systematic routine, starting from the case's address. The matching was within the age groups 7-9, 10-14 and 15-19 years. RESULTS: Analysis was conducted among 169 cases and 477 controls. For the efficacy of BCG revaccination against TB overall, matched (crude) vaccine effectiveness (VE) was -3 (95% CI -50-29) and matched (adjusted) VE was 8 (95% CI -77-52). CONCLUSIONS: This study suggests that a second dose of BCG does not offer additional protection. Revaccination should not be offered. As large numbers of subjects are already vaccinated and vaccine appears to offer some protection in older subjects, further studies with larger sample sizes could investigate the potential efficacy of revaccination with BCG in the age group > or = 15 years

Biogeochemical cycling in terrestrial ecosystems of the Caatinga Biome

The biogeochemical cycles of C, N, P and water, the impacts of land use in the stocks and flows of these elements and how they can affect the structure and functioning of Caatinga were reviewed. About half of this biome is still covered by native secondary vegetation. Soils are deficient in nutrients, especially N and P. Average concentrations of total soil P and C in the top layer (0-20 cm) are 196 mg kg-1 and 9.3 g kg-1, corresponding to C stocks around 23 Mg ha-1. Aboveground biomass of native vegetation varies from 30 to 50 Mg ha-1, and average root biomass from 3 to 12 Mg ha-1. Average annual productivities and biomass accumulation in different land use systems vary from 1 to 7 Mg ha-1 year-1. Biological atmospheric N2 fixation is estimated to vary from 3 to 11 kg N ha-1 year-1and 21 to 26 kg N ha-1 year-1 in mature and secondary Caatinga, respectively. The main processes responsible for nutrient and water losses are fire, soil erosion, runoff and harvest of crops and animal products. Projected climate changes in the future point to higher temperatures and rainfall decreases. In face of the high intrinsic variability, actions to increase sustainability should improve resilience and stability of the ecosystems. Land use systems based on perennial species, as opposed to annual species, may be more stable and resilient, thus more adequate to face future potential increases in climate variability. Long-term studies to investigate the potential of the native biodiversity or adapted exotic species to design sustainable land use systems should be encouraged