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Vitamin A supplements, routine immunization, and the subsequent risk of Plasmodium infection among children under 5 years in sub-Saharan Africa.

Hollm-Delgado MG, Piel FB, Weiss DJ, Howes RE, Stuart EA, Hay SI, Black RE - Elife (2015)

Bottom Line: Bacille Calmette Guerin-vaccinated children were more likely to be PfHRP-2 positive (relative risk [RR]=4.06, 95% confidence interval [CI]=2.00-8.28).Measles and polio vaccination were not associated with malaria.Future studies focusing on climate seasonality, placental malaria and HIV are needed to characterize better the association between vitamin A and malaria infection in different settings.

View Article: PubMed Central - PubMed

Affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States.

ABSTRACT
Recent studies, partly based on murine models, suggest childhood immunization and vitamin A supplements may confer protection against malaria infection, although strong evidence to support these theories in humans has so far been lacking. We analyzed national survey data from children aged 6-59 months in four sub-Saharan African countries over an 18-month time period, to determine the risk of Plasmodium spp. parasitemia (n=8390) and Plasmodium falciparum HRP-2 (PfHRP-2)-related antigenemia (n=6121) following vitamin A supplementation and standard vaccination. Bacille Calmette Guerin-vaccinated children were more likely to be PfHRP-2 positive (relative risk [RR]=4.06, 95% confidence interval [CI]=2.00-8.28). No association was identified with parasitemia. Measles and polio vaccination were not associated with malaria. Children receiving vitamin A were less likely to present with parasitemia (RR=0.46, 95% CI=0.39-0.54) and antigenemia (RR=0.23, 95% CI=0.17-0.29). Future studies focusing on climate seasonality, placental malaria and HIV are needed to characterize better the association between vitamin A and malaria infection in different settings.

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Related in: MedlinePlus

Proportion of children tested according to type of diagnostic used.
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fig3: Proportion of children tested according to type of diagnostic used.

Mentions: We apologize for the confusion. From 20,948 children who presented health cards duringsurvey interviews, 18,413 were eligible for blood screening from which 12,058 providedcapillary blood for malaria testing. Author responseimage 1 shows that 99.8% of children were tested with blood film, and morethan 70% were tested using both blood film and RDT. Less than 0.5% were tested usingonly RDT. The 12,028 tested using thick films and 8702 tested using RDT’s comefrom the 12,058 subjects providing blood, and not the 20,948 children who presentedhealth cards. We recognize that the flow chart (Figure1 in our original paper) may not have been clear on this point, and have nowincluded a statement describing the breakdown of diagnostic tests used, in the Resultssection of the manuscript. Also, as requested by reviewers, Table 1 now only includes children with blood film microscopyresults.Author response image 1.


Vitamin A supplements, routine immunization, and the subsequent risk of Plasmodium infection among children under 5 years in sub-Saharan Africa.

Hollm-Delgado MG, Piel FB, Weiss DJ, Howes RE, Stuart EA, Hay SI, Black RE - Elife (2015)

Proportion of children tested according to type of diagnostic used.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383226&req=5

fig3: Proportion of children tested according to type of diagnostic used.
Mentions: We apologize for the confusion. From 20,948 children who presented health cards duringsurvey interviews, 18,413 were eligible for blood screening from which 12,058 providedcapillary blood for malaria testing. Author responseimage 1 shows that 99.8% of children were tested with blood film, and morethan 70% were tested using both blood film and RDT. Less than 0.5% were tested usingonly RDT. The 12,028 tested using thick films and 8702 tested using RDT’s comefrom the 12,058 subjects providing blood, and not the 20,948 children who presentedhealth cards. We recognize that the flow chart (Figure1 in our original paper) may not have been clear on this point, and have nowincluded a statement describing the breakdown of diagnostic tests used, in the Resultssection of the manuscript. Also, as requested by reviewers, Table 1 now only includes children with blood film microscopyresults.Author response image 1.

Bottom Line: Bacille Calmette Guerin-vaccinated children were more likely to be PfHRP-2 positive (relative risk [RR]=4.06, 95% confidence interval [CI]=2.00-8.28).Measles and polio vaccination were not associated with malaria.Future studies focusing on climate seasonality, placental malaria and HIV are needed to characterize better the association between vitamin A and malaria infection in different settings.

View Article: PubMed Central - PubMed

Affiliation: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, United States.

ABSTRACT
Recent studies, partly based on murine models, suggest childhood immunization and vitamin A supplements may confer protection against malaria infection, although strong evidence to support these theories in humans has so far been lacking. We analyzed national survey data from children aged 6-59 months in four sub-Saharan African countries over an 18-month time period, to determine the risk of Plasmodium spp. parasitemia (n=8390) and Plasmodium falciparum HRP-2 (PfHRP-2)-related antigenemia (n=6121) following vitamin A supplementation and standard vaccination. Bacille Calmette Guerin-vaccinated children were more likely to be PfHRP-2 positive (relative risk [RR]=4.06, 95% confidence interval [CI]=2.00-8.28). No association was identified with parasitemia. Measles and polio vaccination were not associated with malaria. Children receiving vitamin A were less likely to present with parasitemia (RR=0.46, 95% CI=0.39-0.54) and antigenemia (RR=0.23, 95% CI=0.17-0.29). Future studies focusing on climate seasonality, placental malaria and HIV are needed to characterize better the association between vitamin A and malaria infection in different settings.

Show MeSH
Related in: MedlinePlus