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BCG is recommended at birth, but it is often delayed.

Furthermore, BCG is not administered to low-birth-weight (LBW) children at birth in many countries.

Earlier administration of BCG could potentially save many children in infancy.

In an observational study, LBW children who had received BCG at birth had 57% lower mortality before they received diphtheria-tetanus-pertussis (DTP) vaccination than BCG-unvaccinated LBW children [4].

The Bandim Health Project (BHP) in Guinea-Bissau runs a health and demographic surveillance system in 6 districts with a population of around 102,000, including 30% of the inhabitants of the capital. All authors contributed to and approved the final version of the paper.

About 3000 children are born in the BHP study area each year. was responsible for the statistical analysis and P. Independence: The sponsors had no role in the study design, data collection, data analysis, data interpretation, or the writing of the report.

At the first visit after 12 months of age, 229 of these had died before reaching 12 months of age (9.9%), and 1563 (67.4%) were seen at home; 94% (1475) of these children had their vaccination card seen (Figure 1).

The mortality curves for the 2 groups are depicted in Figure 2. Observational studies in low-income countries [4–12] and historical data [13–17] have suggested that the tuberculosis vaccine BCG may have nonspecific beneficial effects on child survival.If BCG has a beneficial nonspecific effect, it would have major implications in low-income countries.This could be important for public health because BCG is often delayed in low-income countries.Several studies from West Africa have shown that vaccinations and micronutrient supplements used routinely in low-income countries have nonspecific effects on mortality [1–3].

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  1. While pair-bonds of varying forms were recognized by most societies as acceptable social arrangements, marriage was reserved for heterosexual pairings and had a transactional nature, where wives were in many cases a form of property being exchanged between father and husband, and who would have to serve the function of reproduction.