Immunological response to Vibrio cholerae O1 infection and an oral cholera vaccine among Peruvians.

A 'double-blind', randomized, placebo controlled study of an oral inactivated whole cell plus recombinant B subunit (WC/rBS) cholera vaccine was conducted during February-March 1992 in Peru in 346 military recruits, 307 (89%) of whom received 2 oral doses of vaccine or Escherichia coli K12 placebo, 2 weeks apart. Paired serum samples were obtained from 155 (50%) of the recipients of 2 doses. An epidemic of cholera took place between doses. No difference in cholera attack rates was detected between vaccine and placebo recipients after one dose (8% versus 14%). Seroconversion (4-fold or higher increase in vibriocidal antibody titres) was detected in 90% and 80% of vaccine and placebo recipients, respectively, with low pre-existing vibriocidal titres (< 0.01). The anti-cholera toxin seroconversion rate among those with low pre-existing titres was higher in vaccinated subjects (97%) than in placebo recipients (68%) (P < 0.01). Administration of 2 doses of WC/rBS vaccine concomitantly with natural V. cholerae O1 infection enhanced the serum anti-cholera toxin response. The immune response to the whole cell component of the vaccine was reduced by high pre-existing vibriocidal antibody titres.

[Evaluation of the Program of the Feeding and Language Stimulation Centers in 3 Chilean regions]. / Evaluación del Programa Centros de Alimentación y Estimulación del Lenguaje en tres regiones del país.

To evaluate the effect of attendance to a non traditional day care center ("CADEL") on physical and psychomotor development, 366 children aged 2-5 years belonging to 22 centers were studied. Weight and height were measured at 0, 4 and 8 months and weight for age, height for age and weight for height indexes were calculated from WHO/NCHS standards. Psychomotor development at the beginning of the study and 8 months latter through a standard test (TEPSI) was evaluated. Mean weight and height monthly increments were 144 +/- 83 g and 0.54 +/- 0.16 cm, 72 and 90% respectively of normal growth. Protein energy malnutrition prevalence (30.8%) was not modified but subnormal values of psychomotor development (40.9%) decreased during the study (p less than 0.05 global, coordination and motor function). Language retardation did not improve with the attendance to the program. These centers represent low cost alternatives to extended coverage of preschool services for low income families. More active family integration and reinforcement of stimulation and educational activities may improve program effectiveness.