Environmental Enteropathy, Oral Vaccine Failure and Growth Faltering in Infants in Bangladesh

Environmental enteropathy (EE) is a subclinical enteric condition found in low-income countries that is characterized by intestinal inflammation, reduced intestinal absorption, and gut barrier dysfunction. We aimed to assess if EE impairs the success of oral polio and rotavirus vaccines in infants i...

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Bibliographic Details
Published in:EBioMedicine 2015-11, Vol.2 (11), p.1759-1766
Main Authors: Naylor, Caitlin, Lu, Miao, Haque, Rashidul, Mondal, Dinesh, Buonomo, Erica, Nayak, Uma, Mychaleckyj, Josyf C., Kirkpatrick, Beth, Colgate, Ross, Carmolli, Marya, Dickson, Dorothy, van der Klis, Fiona, Weldon, William, Steven Oberste, M., Ma, Jennie Z., Petri, William A.
Format: Article
Language:English
Subjects:
Administration, Oral
Bangladesh - epidemiology
Biomarkers
Cluster Analysis
Cohort Studies
Environmental enteropathy
Female
Humans
Infant
Infant Nutrition Disorders - epidemiology
Infant Nutrition Disorders - etiology
Infant Nutrition Disorders - metabolism
Infant, Newborn
Intestinal Diseases - epidemiology
Intestinal Diseases - etiology
Intestinal Diseases - metabolism
Intestinal Diseases - prevention & control
Male
Malnutrition
Oral vaccine failure
Outcome Assessment, Health Care
Public Health Surveillance
Socioeconomic Factors
Urban Population
Vaccination - methods
Vaccination - statistics & numerical data
Vaccines - administration & dosage
Vaccines - immunology
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Summary:Environmental enteropathy (EE) is a subclinical enteric condition found in low-income countries that is characterized by intestinal inflammation, reduced intestinal absorption, and gut barrier dysfunction. We aimed to assess if EE impairs the success of oral polio and rotavirus vaccines in infants in Bangladesh. We conducted a prospective observational study of 700 infants from an urban slum of Dhaka, Bangladesh from May 2011 to November 2014. Infants were enrolled in the first week of life and followed to age one year through biweekly home visits with EPI vaccines administered and growth monitored. EE was operationally defied as enteric inflammation measured by any one of the fecal biomarkers reg1B, alpha-1-antitrypsin, MPO, calprotectin, or neopterin. Oral polio vaccine success was evaluated by immunogenicity, and rotavirus vaccine response was evaluated by immunogenicity and protection from disease. This study is registered with ClinicalTrials.gov, number NCT01375647. EE was present in greater than 80% of infants by 12weeks of age. Oral poliovirus and rotavirus vaccines failed in 20.2% and 68.5% of the infants respectively, and 28.6% were malnourished (HAZ
ISSN:2352-3964
2352-3964
DOI:10.1016/j.ebiom.2015.09.036