title: Lymphocyte response to tetanus toxoid among Indonesian men immunized with tetanus-diphtheria during extended chloroquine or primaquine prophylaxis.
abstract: Immune suppression, a potential side effect of long-term chemoprophylaxis, was evaluated as part of a randomized, placebo-controlled trial that compared daily primaquine against weekly chloroquine for malaria prevention. In the last month of the year-long trial, baseline in vitro lymphoproliferative responses to tetanus toxoid were measured, and a tetanus-diphtheria (Td) immunization was administered. Proliferative responses to tetanus toxoid in each Td-immunized group increased significantly over pre-Td baselines and those of the unvaccinated control. Highest initial responses were measured in the primaquine group. The proportion of responders and the magnitude of proliferation was consistently low in the chloroquine group, and end point responses in this group were significantly below those of the placebo. These results suggest that the development and duration of the cellular response to tetanus immunization was impaired by long-term weekly chloroquine prophylaxis, while daily primaquine prophylaxis over the same time period had no inhibitory effect.
authors.affiliation: US Naval Medical Research Unit No. 2 and National Institute of Health Research, Jakarta, Indonesia.
authors.forename: D J
authors.initials: DJ
authors.lastname: Fryauff
authors.forename: L W
authors.initials: LW
authors.lastname: Church
authors.forename: A L
authors.initials: AL
authors.lastname: Richards
authors.forename: H
authors.initials: H
authors.lastname: Widjaja
authors.forename: E
authors.initials: E
authors.lastname: Mouzin
authors.forename: S
authors.initials: S
authors.lastname: Ratiwayanto
authors.forename: H
authors.initials: H
authors.lastname: Hadiputranto
authors.forename: M A
authors.initials: MA
authors.lastname: Sutamihardja
authors.forename: T L
authors.initials: TL
authors.lastname: Richie
authors.forename: B
authors.initials: B
authors.lastname: Subianto
authors.forename: E
authors.initials: E
authors.lastname: Tjitra
authors.forename: S L
authors.initials: SL
authors.lastname: Hoffman
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000009:adverse effects* / Q000627:therapeutic use; D002738:Chloroquine / Q000009:adverse effects* / Q000627:therapeutic use; D004168:Diphtheria Toxoid / Q000276:immunology*; D022422:Diphtheria-Tetanus Vaccine; D006801:Humans; D007108:Immune Tolerance / Q000187:drug effects; D007117:Immunization, Secondary; D016867:Immunocompromised Host / Q000276:immunology; D008213:Lymphocyte Activation / Q000187:drug effects*; D008288:Malaria / Q000517:prevention & control; D008297:Male; D011319:Primaquine / Q000009:adverse effects* / Q000627:therapeutic use; D013601:T-Lymphocytes / Q000276:immunology; D013745:Tetanus Toxoid / Q000276:immunology*; D014611:Vaccination; D017778:Vaccines, Combined / Q000276:immunology
chemical_list: D000962:Antimalarials; D004168:Diphtheria Toxoid; D022422:Diphtheria-Tetanus Vaccine; D013745:Tetanus Toxoid; D017778:Vaccines, Combined; D002738:Chloroquine; D011319:Primaquine