Maria E Sundaram1, Julian Wolfson2, Michael Osterholm2, Samba Sow3, Patrick Odum Ansah4, Aldiouma Diallo5, Sarah E Cusick6. 1. ICES, Toronto, ON, Canada. Electronic address: maria.sundaram@ices.on.ca. 2. University of Minnesota School of Public Health, Minneapolis, MN, USA. 3. Centre pour Développement des Vaccins, Ministère de la Santé, Bamako, Mali. 4. Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana. 5. UMR257, VITROME, Institut de Recherche pour le Développement, Senegal. 6. Department of Pediatrics, University of Minnesota School of Medicine, Minneapolis, MN, USA.
Abstract
BACKGROUND: Vaccines to prevent meningococcal meningitis in the African meningitis belt include PsACWY, a polysaccharide-only vaccine; and PsA-TT, a polysaccharide-protein conjugate vaccine. Protein-energy undernutrition, a condition where children do not receive enough macro- or micronutrients, is related to increased risk of infectious diseases and poor immune function. Reduced immune function could affect vaccine immunogenicity. We investigated connections between protein-energy undernutrition and vaccine immunogenicity and antibody waning to PsACWY and PsA-TT in children in the African meningitis belt. METHODS: This is a secondary analysis of data collected as part of four clinical trials testing the safety and efficacy of PsA-TT in children in Mali, Ghana, and Senegal. We identified whether anthropometric growth indices (low height-for-age, weight-for-height, or weight-for-age Z-score categories) were related to reduced vaccine-elicited antibody (measured with rabbit complement) from pre- to 1 month post-vaccination, in linear regression models. We also identified whether these growth indices were related to increased waning for vaccine-elicited antibody over time, in linear regression models. RESULTS: A total of 697 children were included in our analysis, of which 350 (50.2%) were female; the mean (SD) age was 1.0 (1.1) years, and 578 (83.0%) received PsA-TT. In linear regression models, no consistent statistical relationship was seen between pre-vaccination anthropometric Z-score categories and vaccine immunogenicity, or decline in antibody over time, for either vaccine, although children with low weight-for-height had a greater decline in antibody from 1 to 6 months post-vaccination. CONCLUSIONS: Our analysis did not find protein-energy undernutrition to be associated with immunogenicity or waning of PsACWY- or PsA-TT-elicited antibody in children living in the African meningitis belt. Future studies should consider measuring antibody titers at additional time points post-vaccination, and for longer periods of time, to determine if the rate of antibody waning over a period of several years is associated with protein-energy undernutrition.
BACKGROUND: Vaccines to prevent meningococcal meningitis in the African meningitis belt include PsACWY, a polysaccharide-only vaccine; and PsA-TT, a polysaccharide-protein conjugate vaccine. Protein-energy undernutrition, a condition where children do not receive enough macro- or micronutrients, is related to increased risk of infectious diseases and poor immune function. Reduced immune function could affect vaccine immunogenicity. We investigated connections between protein-energy undernutrition and vaccine immunogenicity and antibody waning to PsACWY and PsA-TT in children in the African meningitis belt. METHODS: This is a secondary analysis of data collected as part of four clinical trials testing the safety and efficacy of PsA-TT in children in Mali, Ghana, and Senegal. We identified whether anthropometric growth indices (low height-for-age, weight-for-height, or weight-for-age Z-score categories) were related to reduced vaccine-elicited antibody (measured with rabbit complement) from pre- to 1 month post-vaccination, in linear regression models. We also identified whether these growth indices were related to increased waning for vaccine-elicited antibody over time, in linear regression models. RESULTS: A total of 697 children were included in our analysis, of which 350 (50.2%) were female; the mean (SD) age was 1.0 (1.1) years, and 578 (83.0%) received PsA-TT. In linear regression models, no consistent statistical relationship was seen between pre-vaccination anthropometric Z-score categories and vaccine immunogenicity, or decline in antibody over time, for either vaccine, although children with low weight-for-height had a greater decline in antibody from 1 to 6 months post-vaccination. CONCLUSIONS: Our analysis did not find protein-energy undernutrition to be associated with immunogenicity or waning of PsACWY- or PsA-TT-elicited antibody in children living in the African meningitis belt. Future studies should consider measuring antibody titers at additional time points post-vaccination, and for longer periods of time, to determine if the rate of antibody waning over a period of several years is associated with protein-energy undernutrition.
Authors: Samba O Sow; Brown J Okoko; Aldiouma Diallo; Simonetta Viviani; Ray Borrow; George Carlone; Milagritos Tapia; Adebayo K Akinsola; Pascal Arduin; Helen Findlow; Cheryl Elie; Fadima Cheick Haidara; Richard A Adegbola; Doudou Diop; Varsha Parulekar; Julie Chaumont; Lionel Martellet; Fatoumata Diallo; Olubukola T Idoko; Yuxiao Tang; Brian D Plikaytis; Prasad S Kulkarni; Elisa Marchetti; F Marc LaForce; Marie-Pierre Preziosi Journal: N Engl J Med Date: 2011-06-16 Impact factor: 91.245
Authors: E M Molyneux; A L Walsh; H Forsyth; M Tembo; J Mwenechanya; K Kayira; L Bwanaisa; A Njobvu; G Malenga Journal: Malawi Med J Date: 2003-06 Impact factor: 0.875
Authors: Panchali Roy Chowdhury; Christian Meier; Hewad Laraway; Yuxiao Tang; Abraham Hodgson; Samba O Sow; Godwin C Enwere; Brian D Plikaytis; Prasad S Kulkarni; Marie-Pierre Preziosi; Matthias Niedrig Journal: Clin Infect Dis Date: 2015-11-15 Impact factor: 9.079