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Measles vaccination in severely malnourished Sudanese children
Insights
Severely malnourished children showed a robust immune response to measles vaccination, though with increased fever and respiratory illness. Antibody levels varied based on malnutrition severity, impacting vaccine effectiveness.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Childhood malnutrition significantly impacts immune system development and function.
- Measles remains a major cause of mortality in malnourished children, necessitating effective vaccination strategies.
Purpose of the Study:
- To compare the clinical and serological responses to an attenuated measles virus vaccine in severely malnourished versus well-nourished children.
- To evaluate the effect of vitamin B12 supplementation on the immune response in malnourished children.
Main Methods:
- A comparative study involving three groups of children: severely malnourished vaccinated, well-nourished vaccinated, and severely malnourished controls receiving vitamin B12.
- Clinical observations for three weeks post-vaccination, including temperature, respiratory symptoms, and skin rashes.
- Paired serum samples analyzed for measles antibody titers using the hemagglutination inhibition (HAI) technique.
Main Results:
- Malnourished children experienced prolonged fever and increased lower respiratory tract infections post-vaccination compared to well-nourished children.
- Sero-conversion rates were high in both malnourished (96%) and well-nourished (92.6%) vaccinated groups.
- Children with marasmic/kwashiorkor exhibited lower measles antibody titers than those with only marasmus.
Conclusions:
- Attenuated measles virus vaccine elicits a significant serological response in severely malnourished children, despite increased clinical reactions.
- The severity of malnutrition, specifically marasmic/kwashiorkor, influences the antibody response to measles vaccination.
- Vitamin B12 supplementation did not appear to enhance the immune response in this context, warranting further investigation.
Abstract:
The clinical and serological responses to attenuated measles virus vaccine were compared in 35 severely malnourished and 35 well-nourished children. A third group of severely malnourished children, who received an injection of vitamin B12, served as controls. The children were observed for three weeks following vaccination. Paired sera were collected from each child before and after administration of the vaccine or vitamin B12 and measles antibody titres were estimated using HAI technique. The malnourished children who received measles vaccine developed higher fever of longer duration and had more lower respiratory tract disease than the other two groups but had fewer skin rashes than the well-nourished group. Sero-conversion rates were 96% had 92.6% in the malnourished and well-nourished vaccinated children, respectively. Antibody titres were lower in children who had marasmic/kwashiorkor than in the marasmic children.