Use of tuberculin skin test for assessment of immune recovery among previously malnourished children in Ethiopia

• Published in: BMC research notes Vol. 10; no. 1; p. 570
• Main Authors: Bahwere, Paluku, James, Philip, Abdissa, Alemseged, Getu, Yesufe, Getnet, Yilak, Sadler, Kate, Girma, Tsinuel
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07-11-2017; BioMed Central; BMC
• Subjects: Aftercare; Body Size; Care and treatment; Child Nutrition Disorders - immunology; Child Nutrition Disorders - rehabilitation; Child, Preschool; Complications and side effects; Delayed-type hypersensitivity response; Ethiopia; Female; Humans; Immune response; Immunity; Infant; Male; Malnutrition; Morbidity; Patient outcomes; Physiological aspects; Research Note; Severe acute malnutrition; Severity of Illness Index; Tuberculin purified protein derivative; Tuberculin skin test; Tuberculin test; Tuberculin Test - statistics & numerical data; United Kingdom; Delayed-type hypersensitivity response; Severe acute malnutrition; Tuberculin purified protein derivative; Tuberculin skin test; Immunity; Morbidity; Community-based management of acute malnutrition
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/s13104-017-2909-x

To compare levels of immunity in children recovering from severe acute malnutrition (cases) against those of community controls (controls).
At baseline children recovering from severe acute malnutrition had lower, mid upper arm circumference (122 mm for cases and 135 mm for controls; p < 0.001), weight-for-height Z-score (- 1.0 for cases and - 0.5 for controls; p < 0.001), weight-for-age Z-score (- 2.8 for cases and - 1.1 for controls; p < 0.001) and height/length-for-age Z-score (- 3.6 for cases and - 1.4 for controls; p < 0.001), than controls. Age and gender matched community controls. At baseline, prevalence of a positive tuberculin skin test, assessed by cutaneous delayed-type hypersensitivity reaction skin test, was very low in both cases (3/93 = 3.2%) and controls (2/94 = 2.1%) and did not significantly increase at 6 months follow up (6/86 = 7.0% in cases and 3/84 = 3.4% in controls). The incidences of common childhood morbidities, namely fever, diarrhoea and cough, were 1.7-1.8 times higher among cases than controls. In conclusion, these results show that tuberculin skin test does not enable any conclusive statements regarding the immune status of patients following treatment for severe acute malnutrition. The increased incidence of infection in cases compared to controls suggests persistence of lower resistance to infection even after anthropometric recovery is achieved.