TY - JOUR
T1 - Oral polio vaccine response in breast fed infants with malnutrition and diarrhea
AU - Haque, Rashidul
AU - Snider, Cynthia
AU - Liu, Yue
AU - Ma, Jennie Z.
AU - Liu, Lei
AU - Nayak, Uma
AU - Mychaleckyj, Josyf C.
AU - Korpe, Poonum
AU - Mondal, Dinesh
AU - Kabir, Mamun
AU - Alam, Masud
AU - Pallansch, Mark
AU - Oberste, M. Steven
AU - Weldon, William
AU - Kirkpatrick, Beth D.
AU - Petri, William A.
N1 - Funding Information:
We thank the families of Mirpur for their participation in and support for the study. Roland Sutter, Walter Orenstein, Pearay Ogra, Tom Brewer, Chris Wilson, Nic Grassly, and Jacob John have been invaluable sources of advice. We thank William S. Hendley, Yiting Zhang, Sharla L. McDonald, and Deborah D. Moore for the performance of the serum neutralizing antibody responses. Supported by NIH Grant AI-43596 and by the Bill & Melinda Gates Foundation . Conflict of interest : The authors declare that they have no conflicts of interest. Appendix A
PY - 2014/1/16
Y1 - 2014/1/16
N2 - Oral vaccines for polio (OPV) and rotavirus are less effective in children in the developing world. The reasons for this are not well understood. We tested for risk factors for poor response to OPV in infants from an urban slum of Dhaka, Bangladesh. Diminished serum neutralizing response to OPV, but not failure of intramuscularly administered vaccines, was associated with malnutrition, diarrhea, and shorter breastfeeding duration. Children with malnutrition (WAZ <-2) had significantly lower OPV 3 titers (p= 0.029). Children who had 2 or more diarrhea episodes during the 1st months of life were more than twice as likely to experience OPV failure as those who had 1 diarrhea episode or no diarrhea (p= 0.0245). In contrast, each additional month in exclusive breastfeeding was associated with an increase in OPV 3 titer by 0.41 (p= 0.0072) and 0.16 (p= 0.0065) at the 25th and 50th percentiles of OPV 3 titers respectively. These data are consistent with a defect in induction of immunity in the gut for OPV but not parenteral vaccines, a defect that may be amenable to intervention in part via promotion of exclusive breastfeeding.
AB - Oral vaccines for polio (OPV) and rotavirus are less effective in children in the developing world. The reasons for this are not well understood. We tested for risk factors for poor response to OPV in infants from an urban slum of Dhaka, Bangladesh. Diminished serum neutralizing response to OPV, but not failure of intramuscularly administered vaccines, was associated with malnutrition, diarrhea, and shorter breastfeeding duration. Children with malnutrition (WAZ <-2) had significantly lower OPV 3 titers (p= 0.029). Children who had 2 or more diarrhea episodes during the 1st months of life were more than twice as likely to experience OPV failure as those who had 1 diarrhea episode or no diarrhea (p= 0.0245). In contrast, each additional month in exclusive breastfeeding was associated with an increase in OPV 3 titer by 0.41 (p= 0.0072) and 0.16 (p= 0.0065) at the 25th and 50th percentiles of OPV 3 titers respectively. These data are consistent with a defect in induction of immunity in the gut for OPV but not parenteral vaccines, a defect that may be amenable to intervention in part via promotion of exclusive breastfeeding.
UR - http://www.scopus.com/inward/record.url?scp=84891635440&partnerID=8YFLogxK
U2 - 10.1016/j.vaccine.2013.11.056
DO - 10.1016/j.vaccine.2013.11.056
M3 - Article
C2 - 24300591
AN - SCOPUS:84891635440
SN - 0264-410X
VL - 32
SP - 478
EP - 482
JO - Vaccine
JF - Vaccine
IS - 4
ER -