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. 2010 Dec 16;29(2):247-55.
doi: 10.1016/j.vaccine.2010.10.047. Epub 2010 Oct 30.

Effects of maternal and infant co-infections, and of maternal immunisation, on the infant response to BCG and tetanus immunisation

Alison M Elliott  1 , Patrice A Mawa, Emily L Webb, Margaret Nampijja, Nancy Lyadda, Joseph Bukusuba, Moses Kizza, Proscovia B Namujju, Juliet Nabulime, Juliet Ndibazza, Moses Muwanga, James A G Whitworth
Affiliations

Effects of maternal and infant co-infections, and of maternal immunisation, on the infant response to BCG and tetanus immunisation

Alison M Elliott et al. Vaccine. .

Abstract

Some vaccines show poor efficacy in tropical countries. Within a birth cohort in Uganda, we investigated factors that might influence responses to BCG and tetanus immunisation. Whole blood assay responses to crude culture filtrate proteins of Mycobacterium tuberculosis (cCFP)) and tetanus toxoid (TT) were examined among 1506 and 1433 one-year-olds, respectively. Maternal Mansonella perstans infection was associated with higher interleukin (IL)-10 responses to both immunogens but no reduction in gamma interferon (IFN-γ), IL-5 and IL-13 responses; other maternal helminth infections showed little effect. Tetanus immunisation during pregnancy was associated with higher infant responses to TT; maternal BCG scar (from past immunisation) with lower infant IL-5 and IL-13 responses to cCFP. IFN-γ, IL-5 and IL-13 to TT were reduced in HIV-exposed-uninfected infants; infant malaria and HIV were associated with lower IFN-γ, IL-5 and IL-13 responses to both immunogens. We conclude that maternal helminth infections are unlikely to explain poor vaccine efficacy in the tropics. Effects of maternal immunisation on infant responses to vaccines should be explored. Prevention of infant malaria and HIV could contribute to effectiveness of immunisation programmes.

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Figures

Fig. 1
Fig. 1
Study area.
Fig. 2
Fig. 2
Causal diagram.
Fig. 3
Fig. 3
Flow of participants through the study.
Fig. 4
Fig. 4
Cytokine responses measured in supernatant of a six-day whole blood assay among infants aged one year. (A) Responses to crude culture filtrate proteins of Mycobacterium tuberculosis among infants who received BCG immunisation at birth. (B) Responses to tetanus toxoid among infants who received three doses of tetanus immunistaion during infancy. The central line represents the median; boxes represent 75th and 25th centiles; whiskers represent upper and lower adjacent values and dots represent outside values.
See this image and copyright information in PMC

References

    1. Labeaud A.D., Malhotra I., King M.J., King C.L., King C.H. Do antenatal parasite infections devalue childhood vaccination? PLoS Negl Trop Dis. 2009;3(5):e442. - PMC - PubMed
    1. Colditz G.A., Berkey C.S., Mosteller F., Brewer T.F., Wilson M.E., Burdick E. The efficacy of bacillus Calmette-Guerin vaccination of newborns and infants in the prevention of tuberculosis: meta-analyses of the published literature. Pediatrics. 1995;96(1 Pt 1):29–35. - PubMed
    1. Fine P.E. Variation in protection by BCG: implications of and for heterologous immunity. Lancet. 1995;346(8986):1339–1345. - PubMed
    1. WHO. Global tuberculosis control – epidemiology, strategy, financing. WHO/HTM/TB/2009411; 2009.
    1. Beresford B., Sadoff J.C. Update on research and development pipeline: tuberculosis vaccines. Clin Infect Dis. 2010;50(Suppl. 3):S178–S183. - PubMed

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