Anthropometric status, serum prealbumin level and immune response to measles vaccination in Mali children.

Protein energy malnutrition (PEM) is known to depress cell-mediated immunity. Its effect on humoral immunity is less clear-cut. The purpose of the study was to assess seroconversion following measles vaccination according to child nutritional status as assessed by anthropometry and serum thyroxine-binding prealbumin (TBPA). Prior to vaccination, 200 Malian children aged 8-22 months (mode: 9 months) and free of infection were weighed and measured. A venous blood sample was drawn for determination of serum TBPA by radial immunodiffusion and of measles specific immunoglobulins (Ig) by Enzyme-linked Immuno-Sorbent Assay (ELISA). IgG and IgM were again assayed 6 weeks post-vaccination after excluding pre-immune subjects. Seroconversion took place in 91 per cent of the children (95 per cent confidence interval: 86-96 per cent). Based on the NCHS standards, 30 per cent of the children were wasted (weight-for-height less than -2.0 SD) and 18 per cent were stunted (height-for-age less than -2.0 SD). Low serum TBPA (less than 10 mg/dl) was found in 38 per cent of them. TBPA was significantly correlated with weight-for-height and weight-for-age (P less than 0.001), but not with height-for-age. Seroconversion was not significantly related to age, anthropometric indices or TBPA. This study using sensitive methods for the assessment of protein status and of the immune response confirms that children should be vaccinated against measles irrespective of their nutritional status, and PEM was not shown to impair their antibody response.