Protein and Calorie Malnutrition, Cell-Mediated Immunity, and B.C.G. Vaccination in Children From Rural West Bengal

Sinha, Debasish; Bang, Frederik B.

doi:10.1016/s0140-6736(76)91791-8

Cited by 55 publications

(28 citation statements)

References 10 publications

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“…Poor nutritional status has been reported to decrease TST reactivity in children. 29,30 In these studies, severe malnutrition was shown to depress immune responsiveness to BCG, although there was some uncertainty about the effect of mild malnutrition. We did not find an association between TST induration and nutritional status, similar to what was reported previously in The Gambia 18 and in Botswana.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Tuberculosis Infection in Children in Contact With Infectious Tuberculosis Cases in The Gambia, West Africa

et al. 2003

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ABSTRACT. Objective. Tuberculosis (TB) infection is highly prevalent in developing countries. As infected children represent a large proportion of the pool from which TB cases will arise, knowledge of the factors that influence TB infection in children are of importance to evaluate transmission of infection in the community and adapt TB control activities. There are limited data on the risk of infection in child populations in developing countries.Methods. We performed a household contact study in The Gambia (West Africa), in which children who were living in contact with individuals who had proven smearpositive pulmonary TB cases were investigated. A questionnaire was addressed to the mother or caregiver of the child to investigate the presence of various risk factors and assess the degree of exposure of the child to the individual with TB within the household. A tuberculin skin test (TST) was performed on each child. TST sizes >5 and 10 mm, respectively, were considered positive.Results. Households of 206 TB cases were visited, and 384 children aged <5 years were examined. The median age was 2, and 48% were girls. The distribution of TST responses followed a bimodal pattern, with 135 (35%) children presenting a palpable induration. Random effects logistic regression analysis demonstrated that the risk of positive TST response in the child increased with the geographic proximity of the child to the individual with TB within the household and with the degree of activities shared with the individual with TB. It was also associated with the clinical severity of the disease in the index case. Nutritional status and presence of a bacille Calmette-Guérin (BCG) scar were not independent risk factors for TST positivity in this population. On multivariate analysis, the effect of geographic proximity to the individual with TB, household size, and duration of cough in the index case persisted for TST responses >5 mm.Conclusions. In a highly endemic country with high BCG vaccination coverage in Africa, TB infection in children who were in contact with individual with infectious TB was directly related to the intensity of exposure of the child to the individual with TB. Our data suggest that a positive TST in a child reflects most probably TB infection rather than previous BCG vaccination. Contact I n 1995, the World Health Organization estimated that at least 180 million children under the age of 15 years were infected with Mycobacterium tuberculosis worldwide and that nearly 170 000 children died of tuberculosis (TB). 1,2 TB infection and disease among children are much more prevalent in developing countries, where resources for TB control are scarce, than in industrialized countries. 3 However, despite the public health importance of the disease, TB is rarely investigated in children, as the diagnosis is difficult in the young age groups and children are usually not infectious. 4 In addition, contact tracing is rarely done in nonindustrialized countries because of lack of resources, and Isoniazid prophylaxis is not sys...

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Tuberculosis Infection in Children in Contact With Infectious Tuberculosis Cases in The Gambia, West Africa

et al. 2003

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“…(Chen, Chpwdhury and Huffman, 1980;Heywood, 1986;Garenne et al, 1987). A relationship between growth faltering, immune response and risk of morbidity is also documented in the empirical literature (Sinha and Bany, 1976;Kielmann etal., 1976;Tomkins, Dunn and Hayes, 1989). In particular, there appears to be a greater risk of cellular immune dysfunction with poor growth, manifested by an increase in the incidence and duration of morbidity episodes such as diarrhoea (see review by Briend 1990) which is independent of socioeconomic status (Bairagi et al, 1987;El Samani, Willet and Ware, 1989).…”

Section: Sample Selection and Methodsmentioning

confidence: 79%

Seasonal variations in nutritional risk among children in central Mali

Adams¹

1994

Ecology of Food and Nutrition

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This paper examines the effect of seasonality on the nutritional risk of a cohort of 67 under-fives in rural Mali. In the year of study , distinct seasonal trends are apparent for all nutritional indicators: a gradual improvement occurring in the dry season followed by a decline in the rainy season. While significant, these variations are not of sufficient magnitude to affect the prevalence of children falling below -2 standard deviations of the reference population, the threshold level used to define risk. Growth velocity also exhibits a strong seasonal rhythm which overlays a state of chronic mild undernutrition relative to NCHS standards. Coincident with anthropometric trends are seasonal patterns of morbidity which underscore the importance of environmental factors in the aetiology of nutritional risk. Observed differences in the seasonal growth rates of specific age cohorts in the underfive population are the likely result of biological, environmental and/or sociocultural factors such as maternal time constraints militating against regular breastfeeding and supplementary food preparation. While study findings indicate some degree of homeostatic recovery from periods of seasonal stress, the impact of seasonal variation on the long-term health and development of children remains unclear.

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“…Protein deficiency can affect immune responses in young children, depending on its severity. Under extreme malnutrition conditions such as marasmic (severe caloric deficiency), and kwashiorkor (severe protein deficiency) impairment of vaccination was found for yellow fever, smallpox (70), tuberculosis, and polio (71,72). No impairment of the immune response to the vaccination was found under mild and moderate conditions of malnutrition on vaccination against tuberculosis, measles (73,74) smallpox (70,73), yellow fever (70), diphtheria, tetanus, and pertussis (75).…”

Section: Nutrition and Efficacy Of Vaccinationmentioning

confidence: 99%

Vaccine-Induced Antibody Responses as Parameters of the Influence of Endogenous and Environmental Factors

Loveren¹,

Amsterdam²,

Vandebriel³

et al. 2001

Environmental Health Perspectives

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In laboratory animals, an adequate way to assess effects of environmental exposures on the immune system is to study effects on antigen-specific immune responses, such as after sensitization to T-cell-dependent antigens. This probably also applies to testing effects in the human population. It has thus been suggested that antibody responses to vaccination might be useful in this context. Vaccination responses may be influenced by a variety of factors other than environmental ones. One factor is the vaccine itself; a second is the vaccination procedure used. In addition, the intrinsic capacity of the recipient to respond to a vaccine, which is determined by sex, genetic factors, and age, is important. Psychological stress, nutrition, and (infectious) diseases are also likely to have an impact. We reviewed the literature on vaccine response. With regard to exogenous factors, there is good evidence that smoking, diet, psychological stress, and certain infectious diseases affect vaccination titers, although it is difficult to determine to what extent. Genetic factors render certain individuals nonresponsive to vaccination. In general, in epidemiologic studies of adverse effects of exposure to agents in the environment in which vaccination titers are used, these additional factors need to be taken into consideration. Provided that these factors are corrected for, a study that shows an association of exposure to a given agent with diminished vaccination responses may indicate suboptimal function of the immune system and clinically relevant diminished immune response. It is quite unlikely that environmental exposures that affect responses to vaccination may in fact abrogate protection to the specific pathogen for which vaccination was performed. Only in those cases where individuals have a poor response to the vaccine may exogenous factors perhaps have a clinically significant influence on resistance to the specific pathogen. An exposure-associated inhibition of a vaccination response may, however, signify a decreased host resistance to pathogens against which no vaccination had been performed.

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Protein and Calorie Malnutrition, Cell-Mediated Immunity, and B.C.G. Vaccination in Children From Rural West Bengal

Cited by 55 publications

References 10 publications

Risk Factors for Tuberculosis Infection in Children in Contact With Infectious Tuberculosis Cases in The Gambia, West Africa

Risk Factors for Tuberculosis Infection in Children in Contact With Infectious Tuberculosis Cases in The Gambia, West Africa

Seasonal variations in nutritional risk among children in central Mali

Vaccine-Induced Antibody Responses as Parameters of the Influence of Endogenous and Environmental Factors

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