학술논문

Nutritional Status Link with Polioseronegativity Among Children from Poliomyelitis Transmission High-Risk Area of the Democratic Republic of the Congo (DRC)
Document Type
article
Source
Journal of Multidisciplinary Healthcare, Vol Volume 17, Pp 1219-1229 (2024)
Subject
children
underweight
polioserotype
malnutrition
seronegativity
drc
Medicine (General)
R5-920
Language
English
ISSN
1178-2390
Abstract
Guillaume N Mwamba,1,2 Michel Kabamba Nzaji,1,2 Nicole A Hoff,3 Patrick K Mukadi,4 Kamy Kaminye Musene,5 Sue K Gerber,6 Megan Halbrook,3 Cyrus Sinai,3 Trevon Fuller,3 Oscar Luboya Numbi,7 Emile Okitolonda Wemakoy,8 Jean Jacques Muyembe Tamfum,4 Dalau Nkamba Mukadi,8 Mala Ali Mapatano,8,9,* Anne W Rimoin,3,* Paul-Samson Lusamba Dikassa8,* 1Department of Public Health, Faculty of Medicine, University of Kamina, Kamina, Democratic Republic of the Congo; 2Expanded Program on Immunization, Ministry of Health, Kinshasa, Democratic Republic of the Congo; 3Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; 4National Institute of Biomedical Research (INRB), Ministry of Health, Kinshasa, Democratic Republic of the Congo; 5UCLA-DRC Health Research and Training Program, UCLA-DRC, Kinshasa, Democratic Republic of the Congo; 6Polio Eradication program, The Bill and Melinda Gates Foundation, Seattle, WA, 98109, USA; 7Faculty of Medicine, University of Lubumbashi, Lubumbashi, 1825, Democratic Republic of the Congo; 8Department of Epidemiology and Biostatistics, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo; 9Department of Nutrition, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of the Congo*These authors contributed equally to this workCorrespondence: Nicole A Hoff, Field Director for UCLA-DRC Research Program and Researcher at UCLA Fielding School of Public Health, 5345 Av De la Démocratie (Ex Av. Des huileries), Kinshasa, Democratic Republic of the Congo, Tel +1 (240) 409-0578, Email nhoff84@ucla.edu Guillaume N Mwamba, Expanded Program on Immunization, 32 Av De la Justice, Kinshasa-Gombe, Democratic Republic of the Congo, Tel +243817975023, Email guillaumengoiemwamba@gmail.comBackground: Malnutrition is identified as a risk-factor for insufficient polioseroconversion in the context of a vaccine-derived polio virus (VDPV) outbreak prone region. To assess the prevalence of malnutrition and its link to poliovirus insufficient immunity, a cross-sectional household survey was conducted in the regions of Haut- Lomami and Tanganyika, DRC.Methods: In March 2018, we included 968 healthy children aged 6 to 59 months from eight out of 27 districts. Selection of study locations within these districts was done using a stratified random sampling method, where villages were chosen based on habitat characteristics identified from satellite images. Consent was obtained verbally in the preferred language of the participant (French or Swahili) by interviewers who received specific training for this task. Furthermore, participants contributed a dried blood spot sample, collected via finger prick. To assess malnutrition, we measured height and weight, applying WHO criteria to determine rates of underweight, wasting, and stunting. The assessment of immunity to poliovirus types 1, 2, and 3 through the detection of neutralizing antibodies was carried out at the CDC in Atlanta, USA.Results: Of the study population, we found 24.7% underweight, 54.8% stunted, and 15.4% wasted. With IC95%, underweight (OR=1.50; [1.11– 2.03]), and the non-administration of vitamin A (OR=1.96; [1.52– 2.54]) were significantly associated with seronegativity to polioserotype 1. Underweight (OR=1.64; [1.20– 2.24]) and the non-administration of vitamin A (OR=1.55; [1.20– 2.01]) were significantly associated with seronegativity to polioserotype 2. Underweight (OR=1.50; [1.11– 2.03]), and the non-administration of vitamin A (OR=1.80. [1.38– 2.35]) were significantly associated with seronegativity to polioserotype 3. Underweight (OR=1.68; IC95% [1.10– 2.57]) and the non-administration of vitamin A (OR=1.82; IC95% [1.30– 2.55]) were significantly associated with seronegativity to all polioserotypes.Conclusion: This study reveals a significant association between underweight and polioseronegativity in children. In order to reduce vaccine failures in high-risk areas, an integrated approach by vaccination and nutrition programs should be adopted.Keywords: children, underweight, polioserotype, malnutrition, seronegativity, DRC