Related Experiment Videos
Protein and calorie malnutrition, cell-mediated immunity, and B.C.G. vaccination in children from rural West Bengal
Insights
Bacille Calmette-Guérin (BCG) vaccination effectiveness varies with nutritional status. Severe protein deficiency significantly impairs tuberculin test response in children, impacting vaccination program planning.
Area of Science:
- Pediatrics
- Immunology
- Nutritional Science
Background:
- Bacille Calmette-Guérin (BCG) vaccination is widely used to prevent tuberculosis.
- Nutritional status is known to influence immune responses.
- The impact of specific nutritional deficiencies on BCG vaccine efficacy requires further elucidation.
Purpose of the Study:
- To investigate the effect of different types of nutritional deficiencies on the tuberculin test response after BCG vaccination in children.
- To determine if nutritional status impacts the immunogenicity of the BCG vaccine.
Main Methods:
- Retrospective analysis of tuberculin test results in 197 BCG-vaccinated, tuberculin-negative children in West Bengal, India.
- Assessment of nutritional status based on weight-for-age and anthropometric measurements (arm muscle and fat cross-sectional areas) to classify protein and calorie deficiency.
Main Results:
- Overall, 35.5% of children showed a positive tuberculin reaction post-vaccination.
- Children with severe protein deficiency (kwashiorkor) exhibited grossly impaired tuberculin response.
- Children with combined severe protein and calorie deficiency (marasmic-kwashiorkor) showed a significantly depressed response, while those with severe calorie deficiency alone (marasmic) did not.
Conclusions:
- Nutritional status, particularly severe protein deficiency, significantly modulates the immune response to BCG vaccination.
- Distinguishing between types of malnutrition is crucial for effective planning of mass vaccination programs in deficient populations.
- Further research into the immunological mechanisms underlying these observations is warranted.
Abstract:
After B.C.G. vaccination of a group of tuberculin-negative children in West Bengal, India, 197 have been retested with tuberculin. 35-5% showed a definitely positive reaction. Only 15% showed no response to B.C.G. When compared by weight for age, the rate of positivity of those below 60% of the Harvard standard was significantly lower than of those above 80%. Those between 60 and 80% were similar to those above 80%. However, when the group was subdivided according to protein and calorie nutrition as measured by arm muscle and fat cross-sectional areas, the difference was striking. The tuberculin-test response was grossly impaired in those who were primarily severely protein deficient (kwashiorkor type), significantly depressed in those who were both severely protein and severely calorie deficient (marasmic-washiorkor type), and not depressed in those who were severely calorie deficient but normal or low in protein (marasmic type). It is suggested that clear distinction between different types of nutritional deficiency in a given geographic area is of direct relevance in planning mass vaccination programmes in that area.