title: Impact of nutritional status on antibody responses to different vaccines in undernourished Gambian children.
abstract: OBJECTIVE
  To test the efficacy of T-cell-dependent and T-cell-independent vaccines in rural Gambian children suffering from a range of energy/protein and micronutrient deficiencies.
  
  
  METHODS
  Nutritional status (anthropometry, haemoglobin, plasma leptin and micronutrient status) and response to two vaccinations (23 valent pneumococcal capsular polysaccharide vaccine, Pneumovax and the Human Diploid-Cell Rabies Vaccine) were assessed in 472 children aged 6 1/2 h to 9 1/2 y.
  
  
  RESULTS
  Anthropometry and micronutrient status (as z-scores against European reference values) indicated a range from moderate to severe levels of undernutrition [mean (interquartile range): weight-for-age z-score -1.58 (-2.18 to -0.95); height-for-age z-score -0.94 (-1.51 to -0.35); body-mass-index-for-age z-score -1.43 (-2.05 to -0.84); mid-upper arm circumference -1.41 (-1.72 to -1.13); leptin -1.06 (-1.10 to -1.03); haemoglobin (Hb) -0.30 (-1.18 to 0.79); zinc -1.29 (-2.42 to -0.55); vitamin C -0.01 (-1.18 to 1.15); retinol -1.33 (-1.97 to -0.77)]. A seasonal effect was observed in haemoglobin levels and in all micronutrients (with the exception of zinc and retinol) and in the response to vaccination. After adjusting for seasonality, age and gender, no consistent associations were found between any of the measures of nutritional status and the effectiveness of seroconversion to either of the vaccines.
  
  
  CONCLUSIONS
  The successful short-term seroconversion to whole inactivated viral and bacterial polysaccharide vaccines indicates that the processes leading to antibody secretion remain intact over a wide range of single and combined nutrient deficiencies.
authors.affiliation: MRC Keneba, MRC Laboratories, The Gambia. Sophie.Moore@LSHTM.ac.uk
authors.forename: S E
authors.initials: SE
authors.lastname: Moore
authors.forename: D
authors.initials: D
authors.lastname: Goldblatt
authors.forename: C J
authors.initials: CJ
authors.lastname: Bates
authors.forename: A M
authors.initials: AM
authors.lastname: Prentice
mesh_terms: D000917:Antibody Formation / Q000187:drug effects / Q000276:immunology*; D001824:Body Constitution; D002648:Child; D015331:Cohort Studies; D005260:Female; D005714:Gambia; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000172:deficiency* / Q000276:immunology*; D009752:Nutritional Status / Q000187:drug effects / Q000276:immunology*; D022242:Pneumococcal Vaccines / Q000276:immunology* / Q000494:pharmacology; D011502:Protein-Energy Malnutrition / Q000276:immunology*; D011819:Rabies Vaccines / Q000276:immunology* / Q000494:pharmacology; D012424:Rural Population; D013601:T-Lymphocytes / Q000187:drug effects / Q000276:immunology; D013997:Time Factors
chemical_list: D018977:Micronutrients; D022242:Pneumococcal Vaccines; D011819:Rabies Vaccines