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Humoral and cell-mediated immunity in malnourished children in Ghana
T Rikimaru1, K Taniguchi, J E Yartey
1Institute for International Cooperation, JICA, Tokyo, Japan.
Insights
Immunological markers varied with malnutrition severity in Ghanaian children, with complement C3 levels strongly linked to overall malnutrition. Most immune parameters did not differ significantly between specific malnutrition types.
Area of Science:
- Pediatric Nutrition
- Immunology
- Public Health
Background:
- Malnutrition remains a significant public health issue in many developing countries, including Ghana.
- The interplay between nutritional status and the immune system is complex and crucial for child health outcomes.
- Understanding these relationships can inform targeted interventions.
Purpose of the Study:
- To investigate the association between various immunological variables and the types and severity of malnutrition in Ghanaian children.
- To identify specific immune markers that correlate with different malnutrition classifications.
Main Methods:
- A case-control study was conducted involving 170 Ghanaian children aged 8-36 months.
- Participants were categorized into normal, moderately malnourished (underweight), and severely malnourished groups (kwashiorkor, marasmus, marasmic kwashiorkor).
- Immunological status was assessed through serum immunoglobulins, complements, and lymphocyte subpopulations, alongside clinical and anthropometric evaluations.
Main Results:
- Severely malnourished children showed higher serum levels of IgA1, IgA2, and C4, but lower C3 and B cell proportions compared to normal children.
- Complement C3 levels positively correlated with weight-for-height z-score and protein nutrition indicators.
- Most immunological parameters did not differ significantly among the different types of severe malnutrition or between normal and moderately malnourished children.
Conclusions:
- Specific immunological variables demonstrate varying responses to the severity of malnutrition.
- Complement C3 levels appear to be a key indicator closely associated with the overall severity of malnutrition.
- Immune responses are more strongly linked to the degree of malnutrition than to its specific clinical type in this cohort.
Objective:
To examine the relationship between immunological variables and the different types and severity of malnutrition in Ghanaian children.
Design:
Case-control study.
Setting:
The study was done at Princess Marie Louise Hospital, Accra, Ghana.
Subjects:
One hundred and seventy children, aged 8-36 months, were recruited at the clinical ward and public health service section of the hospital: 61 normal children, 49 moderately malnourished (underweight) children and 60 severely malnourished children (19 kwashiorkor, 30 marasmus, and 11 marasmic kwashiorkor children).
Method:
The children underwent clinical observations, anthropometric measurements and blood sampling for biochemical analysis to evaluate their nutritional and immunological status. Serum immunoglobulins (IgA subclasses, IgG subclasses and IgM), complements (C3 and C4) and lymphocyte subpopulations (T cells, B cells, CD4+, CD8+, NK cells and HLADR) were determined for the assessment of humoral and cell-mediated immunity.
Results:
Serum levels of IgA1, IgA2 and C4 tended to be higher in severely malnourished children than in normal children, while serum level of C3 and the proportion of B cells were significantly lower in the severely malnourished children than in the normal children (P < 0.05). There were no notable differences in most immunological parameters among the three severely malnourished groups. No differences were observed in the immunological parameters except for the proportion of B cells between normal and moderately malnourished children. Factor analysis revealed that C3 levels were positively correlated with a factor which was strongly associated with weight-for-height z-score and biochemical indicators for evaluating protein nutrition. In addition, IgA2, IgG1 and IgM levels were positively correlated with a factor which was associated with C-reactive protein.
Conclusion:
Several immunological variables responded positively or negatively with the different levels of severity of malnutrition, but most variables did not on the different types of malnutrition. The changes of C3 level were more associated with the severity of malnutrition.