Department of Biochemistry and Biotechnology, College of Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Kintampo Health Research Centre, Kintampo-North, Ghana.
PLoS One. 2021 Jul 20;16(7):e0253544. doi: 10.1371/journal.pone.0253544. eCollection 2021.
Iron fortification and micronutrient initiatives, specifically, vitamin A, and zinc supplementation are the most cost-effective developmental strategies against malnutrition and health emergencies in pre-school children. Iron-deficiency among pre-school children have been documented, however, studies evaluating the impact of immunoglobulin G (IgG) isotype responses among iron-fortified pre-school children in malaria endemic communities has not been assessed. We evaluated the impact of iron fortification on the IgG responses to GLURP R0, GLURP R2 and MSP3 FVO malaria-specific antigens among pre-school children in malaria endemic areas.
This community-based, placebo-controlled, double-blinded, cluster-randomized trial study was conducted in Wenchi Municipal and Tain District of Bono Region. The trial was registered at ClinicalTrials.gov-registered trial (Identifier: NCT01001871). Ethical approval was obtained and informed consent were sought from each participant parents/guardian. For the current objective, 871 children aged 6-35 months were screened, from which 435 children received semi-liquid home-made meals mixed with 12.5 mg of iron daily (intervention group), and 436 received micronutrient powder without iron (placebo group) for 5 months. Standardized clinical and epidemiological questionnaires were administered and blood samples taken to measure IgG responses to GLURP R0, GLURP R2 and MSP3 FVO recombinant antigens using the Afro Immunoassay (AIA) protocol.
Baseline anthropometry, malaria diagnosis, anaemia and iron status, demographic features and dietary intake were identical among the groups (p > 0.05). After the intervention, there was no significant difference in the IgG response against GLUP R0, GLUP R2 and MSP3 FVO between the iron-containing micronutrient and placebo groups (p > 0.05). The iron-containing micronutrient powder group who were iron-sufficient or iron replete had significantly higher IgG response to GLURP R0 and GLURP R2 compared to iron-deficient and iron-deficiency anaemia in the same group (p < 0.05). The IgG responses to all the three malaria specific antigens were low among children without malaria episode but high among those with two and four episodes due to exposure differences.
Iron fortification did not influence antibody response against endogenous malaria specific antigens among pre-school children in malaria endemic areas, however, IgG response to malaria specific antigens were high among children with sufficient iron status.
铁强化和微量营养素干预措施，特别是维生素 A 和锌补充，是针对学龄前儿童营养不良和健康紧急情况的最具成本效益的发展战略。已经有研究记录了学龄前儿童缺铁的情况，然而，评估铁强化对疟疾流行地区学龄前儿童免疫球蛋白 G（IgG）同种型反应影响的研究尚未进行。我们评估了铁强化对疟疾流行地区学龄前儿童对 GLURP R0、GLURP R2 和 MSP3 FVO 疟疾特异性抗原的 IgG 反应的影响。
这是一项基于社区的、安慰剂对照、双盲、整群随机试验研究，在温奇市和博诺地区的塔因区进行。该试验在 ClinicalTrials.gov 注册（标识符：NCT01001871）。从每个参与者的父母/监护人那里获得了伦理批准和知情同意。在当前的目标中，对 871 名 6-35 个月大的儿童进行了筛查，其中 435 名儿童每天接受含有 12.5 毫克铁的半液态家常餐（干预组），436 名儿童接受不含铁的微量营养素粉（安慰剂组），持续 5 个月。使用 Afro Immunoassay（AIA）方案进行了标准化的临床和流行病学问卷调查，并采集了血液样本，以测量针对 GLURP R0、GLURP R2 和 MSP3 FVO 重组抗原的 IgG 反应。
基线人体测量、疟疾诊断、贫血和铁状况、人口特征和饮食摄入在各组之间完全相同（p > 0.05）。干预后，含铁微量营养素组和安慰剂组之间针对 GLUP R0、GLUP R2 和 MSP3 FVO 的 IgG 反应无显著差异（p > 0.05）。与同组缺铁和缺铁性贫血相比，铁充足或铁充足的含铁微量营养素组对 GLURP R0 和 GLURP R2 的 IgG 反应显著更高（p < 0.05）。没有疟疾发作的儿童对所有三种疟疾特异性抗原的 IgG 反应均较低，但由于暴露差异，有两次和四次疟疾发作的儿童的 IgG 反应较高。
铁强化并未影响疟疾流行地区学龄前儿童针对内源性疟疾特异性抗原的抗体反应，但铁状态充足的儿童对疟疾特异性抗原的 IgG 反应较高。
