Malnutrition and Vaccination in Developing Countries

Overview

Journal Philos Trans R Soc Lond B Biol Sci

Specialty Biology

Date 2015 May 13

PMID 25964453

Citations 82

Authors

Andrew J Prendergast

Affiliations

Soon will be listed here.

Abstract

Malnutrition contributes to an estimated 45% of deaths among children under 5 years of age in developing countries, predominantly due to infections. Malnourished children therefore stand to benefit hugely from vaccination, but malnutrition has been described as the most common immunodeficiency globally, suggesting that they may not be able to respond effectively to vaccines. The immunology of malnutrition remains poorly characterized, but is associated with impairments in mucosal barrier integrity, and innate and adaptive immune dysfunction. Despite this, the majority of malnourished children can mount a protective immune response following vaccination, although the timing, quality and duration of responses may be impaired. This paper reviews the evidence for vaccine immunogenicity in malnourished children, discusses the importance of vaccination in prevention of malnutrition and highlights evidence gaps in our current knowledge.

Citing Articles

Inequality of opportunity in child nutrition in Pakistan.

Sriram S, Naz L PLoS One. 2025; 20(2):e0318425.

PMID: 39982904 PMC: 11844883. DOI: 10.1371/journal.pone.0318425.

Socio-economic and demographic determinants of undernutrition among 6-59 months old children living in Malawian stunting hotspots: a cross-sectional community study.

Ndovie P, Nkhata S, Geresomo N, Fungo R, Nyau V, Munthali J BMC Nutr. 2025; 11(1):14.

PMID: 39833945 PMC: 11745028. DOI: 10.1186/s40795-025-01001-9.

Nutritionally acquired immunodeficiency must be addressed with the same urgency as HIV to end tuberculosis.

Dauphinais M, Koura K, Narasimhan P, Mehta S, Finkelstein J, Heysell S BMC Glob Public Health. 2024; 2(1):4.

PMID: 39681926 PMC: 11622872. DOI: 10.1186/s44263-023-00035-0.

A Case Study on Undernutrition among Children under Five Years of Age in Barangay Calumpang, Nagcarlan, Laguna.

Salvo R, Barrion A, Maneja M, Lanorio M Acta Med Philipp. 2024; 57(4):13-23.

PMID: 39618983 PMC: 11603081. DOI: 10.47895/amp.vi0.3970.

Recovery time and its predictors of severe acute malnutrition among under five children admitted at the therapeutic feeding center of Hiwot Fana comprehensive specialized hospital, eastern Ethiopia, 2024: a semi-parametric model.

Meseret F, Keneni M, Alemu A, Tizazu D, Alemayehu T, Mossie Y Front Nutr. 2024; 11:1450496.

PMID: 39564207 PMC: 11575916. DOI: 10.3389/fnut.2024.1450496.

References

Feller A, Zaman K, Lewis K, Hossain I, Yunus M, Sack D . Malnutrition levels among vaccinated and unvaccinated children between 2 and 3 years of age following enrollment in a randomized clinical trial with the pentavalent rotavirus vaccine (PRV) in Bangladesh. Vaccine. 2012; 30 Suppl 1:A101-5. DOI: 10.1016/j.vaccine.2011.09.065. View

Prendergast A, Kelly P . Enteropathies in the developing world: neglected effects on global health. Am J Trop Med Hyg. 2012; 86(5):756-63. PMC: 3335677. DOI: 10.4269/ajtmh.2012.11-0743. View

Watanabe Ishikawa L, da Rosa L, Franca T, Peres R, Chiuso-Minicucci F, Zorzella-Pezavento S . Is the BCG vaccine safe for undernourished individuals?. Clin Dev Immunol. 2012; 2012:673186. PMC: 3332168. DOI: 10.1155/2012/673186. View

Pronyk P, Muniz M, Nemser B, Somers M, McClellan L, Palm C . The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment. Lancet. 2012; 379(9832):2179-88. DOI: 10.1016/S0140-6736(12)60207-4. View

. Pneumococcal vaccines WHO position paper - 2012 - recommendations. Vaccine. 2012; 30(32):4717-8. DOI: 10.1016/j.vaccine.2012.04.093. View

Anekwe T, Kumar S . The effect of a vaccination program on child anthropometry: evidence from India's Universal Immunization Program. J Public Health (Oxf). 2012; 34(4):489-97. DOI: 10.1093/pubmed/fds032. View

Taylor A, Cao W, Vora K, La Cruz J, Shieh W, Zaki S . Protein energy malnutrition decreases immunity and increases susceptibility to influenza infection in mice. J Infect Dis. 2012; 207(3):501-10. PMC: 11341849. DOI: 10.1093/infdis/jis527. View

Kosek M, Haque R, Lima A, Babji S, Shrestha S, Qureshi S . Fecal markers of intestinal inflammation and permeability associated with the subsequent acquisition of linear growth deficits in infants. Am J Trop Med Hyg. 2012; 88(2):390-396. PMC: 3583335. DOI: 10.4269/ajtmh.2012.12-0549. View

Olofin I, McDonald C, Ezzati M, Flaxman S, Black R, Fawzi W . Associations of suboptimal growth with all-cause and cause-specific mortality in children under five years: a pooled analysis of ten prospective studies. PLoS One. 2013; 8(5):e64636. PMC: 3667136. DOI: 10.1371/journal.pone.0064636. View

10.

Lin A, Arnold B, Afreen S, Goto R, Nurul Huda T, Haque R . Household environmental conditions are associated with enteropathy and impaired growth in rural Bangladesh. Am J Trop Med Hyg. 2013; 89(1):130-137. PMC: 3748469. DOI: 10.4269/ajtmh.12-0629. View

11.

Black R, Victora C, Walker S, Bhutta Z, Christian P, de Onis M . Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 2013; 382(9890):427-451. DOI: 10.1016/S0140-6736(13)60937-X. View

12.

Bhutta Z, Das J, Rizvi A, Gaffey M, Walker N, Horton S . Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost?. Lancet. 2013; 382(9890):452-477. DOI: 10.1016/S0140-6736(13)60996-4. View

13.

Kizito D, Tweyongyere R, Namatovu A, Webb E, Muhangi L, Lule S . Factors affecting the infant antibody response to measles immunisation in Entebbe-Uganda. BMC Public Health. 2013; 13:619. PMC: 3733798. DOI: 10.1186/1471-2458-13-619. View

14.

Christian P, Lee S, Angel M, Adair L, Arifeen S, Ashorn P . Risk of childhood undernutrition related to small-for-gestational age and preterm birth in low- and middle-income countries. Int J Epidemiol. 2013; 42(5):1340-55. PMC: 3816349. DOI: 10.1093/ije/dyt109. View

15.

Keusch G, Rosenberg I, Denno D, Duggan C, Guerrant R, Lavery J . Implications of acquired environmental enteric dysfunction for growth and stunting in infants and children living in low- and middle-income countries. Food Nutr Bull. 2013; 34(3):357-64. PMC: 4643688. DOI: 10.1177/156482651303400308. View

16.

Cox J, Beachkofsky T, Dominguez A . Flaky paint dermatosis. Kwashiorkor. JAMA Dermatol. 2013; 150(1):85-6. DOI: 10.1001/jamadermatol.2013.5520. View

17.

Prendergast A, Rukobo S, Chasekwa B, Mutasa K, Ntozini R, Mbuya M . Stunting is characterized by chronic inflammation in Zimbabwean infants. PLoS One. 2014; 9(2):e86928. PMC: 3928146. DOI: 10.1371/journal.pone.0086928. View

18.

Gaayeb L, Pincon C, Cames C, Sarr J, Seck M, Schacht A . Immune response to Bordetella pertussis is associated with season and undernutrition in Senegalese children. Vaccine. 2014; 32(27):3431-7. DOI: 10.1016/j.vaccine.2014.03.086. View

19.

Jones K, Thitiri J, Ngari M, Berkley J . Childhood malnutrition: toward an understanding of infections, inflammation, and antimicrobials. Food Nutr Bull. 2014; 35(2 Suppl):S64-70. PMC: 4257992. DOI: 10.1177/15648265140352S110. View

20.

Rytter M, Kolte L, Briend A, Friis H, Christensen V . The immune system in children with malnutrition--a systematic review. PLoS One. 2014; 9(8):e105017. PMC: 4143239. DOI: 10.1371/journal.pone.0105017. View