Abstract:
Objective: To compare levels of immunity in children recovering from severe acute malnutrition (cases) against
those of community controls (controls).
Results: 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-forage 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 signifcantly
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.
