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Future Microbiol. 2018 Jul;13:1055-1070. doi: 10.2217/fmb-2018-0016. Epub 2018 Jun 21.

Exploring the relationship between environmental enteric dysfunction and oral vaccine responses.

Author information

1
Zvitambo Institute for Maternal & Child Health Research, Harare, Zimbabwe.
2
Centre for Genomics & Child Health, Blizard Institute, Queen Mary University of London, UK.
3
Department of Infectious Disease Epidemiology, St Mary's Campus, Imperial College London, London, UK.
4
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
5
Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
6
Tropical Gastroenterology & Nutrition group, University of Zambia School of Medicine, Lusaka, Zambia.

Abstract

Oral vaccines significantly underperform in low-income countries. One possible contributory factor is environmental enteric dysfunction (EED), a subclinical disorder of small intestinal structure and function among children living in poverty. Here, we review studies describing oral vaccine responses and EED. We identified eight studies evaluating EED and oral vaccine responses. There was substantial heterogeneity in study design and few consistent trends emerged. Four studies reported a negative association between EED and oral vaccine responses; two showed no significant association; and two described a positive correlation. Current evidence is therefore insufficient to determine whether EED contributes to oral vaccine underperformance. We identify roadblocks in the field and future research needs, including carefully designed studies those can investigate this hypothesis further.

KEYWORDS:

EED; infant; oral vaccine

PMID:
29926747
PMCID:
PMC6136084
DOI:
10.2217/fmb-2018-0016
[Indexed for MEDLINE]
Free PMC Article

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