THE EVALUATION OF DELAYED-TYPE HYPERSENSITIVITY RESPONSIVENESS AND NUTRITIONAL-STATUS AS PREDICTORS OF GASTROINTESTINAL AND ACUTE RESPIRATORY-INFECTION - A PROSPECTIVE FIELD-STUDY AMONG TRADITIONAL NOMADIC KENYAN CHILDREN

A 10-month prospective study of children from a nomadic pastoralist co mmunity in northwest Kenya was conducted to examine the relationship b etween nutritional status, cell-mediated immunity (CMI), and morbidity due to gastroenteritis and acute respiratory infection (ARI), In chil dren ages 6 months to 10 years, nutritional status and cellular immuno competence, determined by delayed-type hypersensitivity (DTH), were re lated to individual attack rates of diarrhoea and ARI over two 5-month observation periods, one each in the wet and dry season, While no ass ociation was found between premorbid nutritional status and gastroente ritis, DTH responsiveness was a significant predictor of diarrhoeal di sease, with anergic children experiencing, on average, 20 per cent hig her attack rates than immunocompetent children, When examined separate ly, both nutritional status and DTH responsiveness were significant pr edictors of individual attack rates of ARI in the wet season, However, when the effects of nutritional and immunological status were simulta neously tested, only DTH responsiveness was significant, Anergic child ren experienced 34 per cent excess ARI, compared to immunocompetent ch ildren, These results indicate that cellular immunocompetence is a sen sitive predictor of gastrointestinal and respiratory infection, and th at the effect of nutritional status on the occurrence of ARI may be me diated by cellular immune function.