Effect of maternal vitamin D supplementation on nasal pneumococcal acquisition, carriage dynamics and carriage density in infants in Dhaka, Bangladesh.

Mahgol Taghivand, Lisa G Pell, Mohammed Z Rahman, Abdullah A Mahmud, Eric O Ohuma, Eleanor M Pullangyeum, Tahmeed Ahmed, Davidson H Hamer, Stanley H Zlotkin, Jonathan B Gubbay, Shaun K Morris, Daniel E Roth

Journal: BMC infectious diseases 2022;22(1):52

PMID: 35026987

Free Full Text on BioMed Central View on PubMed

Abstract

BACKGROUND

Invasive pneumococcal disease is a major cause of infant morbidity and death worldwide. Vitamin D promotes anti-pneumococcal immune responses in vitro, but whether improvements in infant vitamin D status modify risks of nasal pneumococcal acquisition in early life is not known.

METHODS

This is a secondary analysis of data collected in a trial cohort in Dhaka, Bangladesh. Acute respiratory infection (ARI) surveillance was conducted from 0 to 6 months of age among 1060 infants of women randomized to one of four pre/post-partum vitamin D dose combinations or placebo. Nasal swab samples were collected based on standardized ARI criteria, and pneumococcal DNA quantified by qPCR. Hazards ratios of pneumococcal acquisition and carriage dynamics were estimated using interval-censored survival and multi-state modelling.

RESULTS

Pneumococcal carriage was detected at least once in 90% of infants by 6 months of age; overall, 69% of swabs were positive (2616/3792). There were no differences between any vitamin D group and placebo in the hazards of pneumococcal acquisition, carriage dynamics, or carriage density (p > 0.05 for all comparisons).

CONCLUSION

Despite in vitro data suggesting that vitamin D promoted immune responses against pneumococcus, improvements in postnatal vitamin D status did not reduce the rate, alter age of onset, or change dynamics of nasal pneumococcal colonization in early infancy. Trial registration Registered in ClinicalTrials.gov with the registration number of NCT02388516 and first posted on March 17, 2015.

Address: Department of Nutritional Sciences, University of Toronto, Toronto, Canada.; Centre for Global Child Health & Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, Canada.; Infections Diseases Division & Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.; Department of Global Health, Boston University School of Public Health, Boston, USA.; Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, USA.; Department of Pediatrics, Hospital for Sick Children & University of Toronto, 686 Bay Street, Toronto, ON, Canada.; Public Health Ontario, Toronto, ON, Canada.; Department of Nutritional Sciences, University of Toronto, Toronto, Canada. [email protected].; Centre for Global Child Health & Child Health Evaluative Sciences, Hospital for Sick Children, 686 Bay Street, Toronto, ON, Canada. [email protected].; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. [email protected].; Department of Pediatrics, Hospital for Sick Children & University of Toronto, 686 Bay Street, Toronto, ON, Canada. [email protected].

DOI: 10.1186/s12879-022-07032-y

Link outs

Free resources

Full Text Sources:

Medical:

MeSH Terms: Bangladesh, Carrier State, Dietary Supplements, Female, Humans, Infant, Nasopharynx, Pneumococcal Infections, Pneumococcal Vaccines, Streptococcus pneumoniae, Vitamin D, Vitamins