Neisseria Meningitidis, Meningococcal Vaccines and Nutrition in Children in the African Meningitis Belt

Abstract

Abstract Introduction: Human nutrition plays an important role in immune function and protection against infectious diseases. Populations experiencing nutritional deficiencies may benefit less from vaccines (which require robust immune system function) and may be at increased risk of disease. Methods: I identified populations living in the African meningitis belt and assessed potential relationships between 1) protein-energy undernutrition and meningococcal vaccine immunogenicity; 2) iron and vitamin A deficiency and long-term vaccine antibody persistence; and 3) iron status and risk of asymptomatic nasopharyngeal carriage of Neisseria meningitidis (Nm). Results: Protein-energy undernutrition was not consistently significantly related to meningococcal vaccine immunogenicity in children 0-2 years old. However, increasing iron status was significantly related to a reduction in meningococcal vaccine-elicited antibody at 2 years post-vaccination. Finally, increasing iron status was significantly related to reduced odds of asymptomatic nasopharyngeal carriage of Nm in children 5-11 (for iron measured by serum ferritin) and 12-17 (for iron measured by soluble transferrin receptor) years old. Discussion: This dissertation identifies potential relationships between iron status and meningococcal vaccine antibody persistence as well as the odds of Nm carriage. Further studies should assess these relationships in larger populations of children, at a greater number of time points, and consider additional iron biomarkers.