Nutritional status, globulin titers, and parasitic infections of two populations of Tanzanian school children

Abstract

Two schools in rural Tanzania were surveyed regarding the pupils' nutrition (weight and height), serum immunoglobulins (IgA, IgG, IgM, and IgE), autoantibodies, malaria antibodies, hepatitis B antigenemia, and fecal and urinary parasites. The survey attempted to quantify the relative importance of undernutrition and parasitic infestation in determining the serological abnormalities found. Of all the children surveyed 69% were undernourished (less than 80% of expected weight for age); 63% had fecal parasites and 38% had urinary schistosomiasis. Serum IgG and IgM concentrations were raised and the serum IgE concentration was strikingly raised (mean 4990IU/ml). Elevated serum IgE was associated with ascariasis. Autoantibodies were common but no autoimmune disease was detected. Notably there was a 35% prevalence of reticulin antibody. This reticulin antibody positivity correlated with increased malaria antibody concentrations. Reduced malaria antibody concentration was significantly associated with hepatitis B antigenemia. The study illustrates that parasites, notably malaria, are important determinants of the serum antibodies of children in the tropics and suggests that mild undernutrition has little effect.