الفهرس 
Acknowledgementيوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
TUBERCULOSIS (TB) is of major importance in developing countries. Immunization against TB is limited to the bacillus Calmette-Guerin (BCG) vaccine. The WHO recommends a single BCG vaccine at birth in countries with a high prevalence of active TB disease. The presence or absence of a BCG scar is often used as an indicator of previous vaccination in clinical settings as well as surveys performed by health institutions such as the Expanded Program on Immunization to assess vaccine uptake. However, the sensitivity of the BCG scar as an index of vaccination status is still the subject of controversy The present study aimed to estimate the frequency of children without BCG scar after BCG vaccination, estimate frequency of vaccine adverse effects, evaluate factors which may affect scar formation, and determine Tuberculin skin test response in children without BCG scar Our study included 100 cases, their ages ranged from 6 months to 5 years.Attending Assiut University children’s hospital outpatient and vaccinationclinics, from January 2019 to December 2019. All cases included in the study subjected to : Full clinical history including : History of vaccination , age , birth weight , nutritional status , gender , gestational age , weight at time of vaccination , mother awareness , place of vaccination . Detailed clinical examination : including site of BCG scar and nutritional status . Tuberculin test in negative BCG scar children. Revaccination of negative BCG scar children -Results of our study showed that; 77% of studied cases had BCG scar while it was absent in 23% of the cases. Regarding factors affecting scar formation,we found that birth weight and weight at time of vaccination (nutritional status) had a role in BCG scar formation, while gender, gestational age, place of vaccination do not affect its formation . -There was a side effect of BCG vaccine in (12.9%) of cases; raised scar in (15.7%) of cases, keloid recorded in (3.9%) of cases but Abscess, lymphadenitis and disseminated TB were not found in all cases. -Regarding tuberculin skin test response in children with absent BCG scar in this study only one case (4.3%) has positive tuberculin test. -22.7% of children with absent BCG scar and negative tuberculin skin test were revaccinated by BCG vaccine while 77.2% were not. To pay attention to the quality of BCG vaccine, its handling, techniques of application, the training of personnel and the coverage of eligible population. To pay attention to the nutrition of infants and prenatal care of mother as the birth weight of the baby and nutritional status can affect BCG scar formation according to our study . Revaccination of children without BCG scars after testing for TB by the tuberculin skin test . Choose a guaranteed place for vaccination . The need for proper evaluation and monitoring of the BCG vaccination programme is of paramount importance. There should be organized operational research activities in order to yield information that could be used for improving the effectiveness of BCG programmes