Cell‐mediated immunocompetence among nomadic Turkana children

Abstract Cell‐mediated immune function is readily impaired by nutritional and disease stress, while depressed cellular immunity, in turn, increases an individual's susceptibility to infection. The measurement of cellular immunity through delayed‐type hypersensitivity (DTH) testing can provide important prognostic information, including the prediction of future health and survival, and can easily be performed in nonclinical settings. In a sample of 64 nomadic Turkana children, DTH response was measured seasonally by the simultaneous application of five standardized recall antigens and a glycerin control (Multiest CMI®). Reactivity, measured by mm of induration, varied substantially by antigen, with tuberculin eliciting the strongest response. However, the majority of children (56.2%) were nonreactive to all administered test antigens, indicating a level of anergy significantly higher than that found in U.S. and Peruvian juvenile populations. DTH response did not vary by sex or age of the subject. In addition, immunocompetence did not fluctuate seasonally. These results suggest that the level of immunosuppression found among Turkana children is extremely high, and may be an important determinant of the high rates of morbidity and mortality found in this population. © 1993 Wiley‐Liss, Inc.