Evaluating Associations Between Vaccine Response and Malnutrition, Gut Function, and Enteric Infections in the MAL-ED Cohort Study: Methods and Challenges

被引:29
作者
Hoest, Christel [1 ]
Seidman, Jessica C. [1 ]
Pan, William [2 ,3 ]
Ambikapathi, Ramya [1 ]
Kang, Gagandeep [4 ]
Kosek, Margaret [5 ]
Knobler, Stacey [1 ]
Mason, Carl J. [6 ]
Miller, Mark [1 ]
机构
[1] NIH, Div Int Epidemiol & Populat Studies, Fogarty Int Ctr, Bethesda, MD 20892 USA
[2] Duke Univ, Dept Environm Sci & Policy, Durham, NC USA
[3] Duke Univ, Duke Global Hlth Inst, Durham, NC USA
[4] Christian Med Coll & Hosp, Vellore, Tamil Nadu, India
[5] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Baltimore, MD USA
[6] Armed Forces Res Inst Med Sci, Bangkok 10400, Thailand
基金
比尔及梅琳达.盖茨基金会; 美国国家卫生研究院;
关键词
vaccines; malnutrition; enteric infections; gut function; MAL-ED; ANTIBODY-RESPONSES; ROTAVIRUS VACCINES; IMMUNE-RESPONSE; BIRTH COHORT; BREAST-MILK; MEASLES; POLIO; CHILDREN; PROTECTION; SYSTEM;
D O I
10.1093/cid/ciu611
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Most vaccine assessments have occurred in well-nourished populations of higher socioeconomic status. However, vaccines are often used in populations with high incidences of malnutrition and infections, in whom the effectiveness of some vaccines is inferior for unknown reasons. The degree and extent of vaccine underperformance have not been systematically studied for most vaccines across differing epidemiologic settings. This paper outlines the methods used and challenges associated with measuring immunological responses to oral vaccines against poliovirus and rotavirus, and parenteral vaccines against pertussis, tetanus, and measles in an observational study that monitored daily illness, monthly growth, intestinal inflammation and permeability, pathogen burden, dietary intake, and micronutrient status in children in 8 countries. This evaluation of vaccine response in the context of low- and middle-income countries is intended to address the gaps in knowledge of the heterogeneity in vaccine response in diverse epidemiological settings and the interplay between infections, nutrition, and immune response.
引用
收藏
页码:S273 / S279
页数:7
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