Sun protection to improve vaccine effectiveness in children in a high ambient ultraviolet radiation and rural environment : an intervention study

dc.contributor.authorWright, Caradee Yael
dc.contributor.authorAlbers, Patricia N.
dc.contributor.authorMathee, Angela
dc.contributor.authorKunene, Zamantimande
dc.contributor.authorD’Este, Catherine
dc.contributor.authorSwaminathan, Ashwin
dc.contributor.authorLucas, Robyn M.
dc.date.accessioned2017-02-01T08:25:09Z
dc.date.available2017-02-01T08:25:09Z
dc.date.issued2017-01-06
dc.description.abstractBACKGROUND : Vaccination is a mainstay of preventive healthcare, reducing the incidence of serious childhood infections. Ecological studies have demonstrated an inverse association between markers of high ambient ultraviolet (UV) radiation exposure (e.g., sunny season, low latitude of residence) and reduction in the vaccination-associated immune response. Higher sun exposure on the day prior to and spanning the day of vaccination has been associated with a reduced antigen-specific immune response independent of skin pigmentation. The South African Department of Health’s Expanded Programme on Immunisation provides free vaccinations in government primary health care clinics. In some areas, these clinics may have only a small waiting room and patients wait outside in full sun conditions. In rural areas, patients may walk several kilometres to and from the clinic. We hypothesised that providing sun protection advice and equipment to mothers of children (from 18 months) who were waiting to be vaccinated would result in a more robust immune response for those vaccinated. METHODS : We conducted an intervention study among 100 children receiving the booster measles vaccination. We randomised clinics to receive (or not) sun protection advice and equipment. At each clinic we recorded basic demographic data on the child and mother/carer participants, their sun exposure patterns, and the acceptability and uptake of the provided sun protection. At 3–4 weeks post-vaccination, we measured measles IgG levels in all children. DISCUSSION : This is the first intervention study to assess the effect of sun protection measures on vaccine effectiveness in a rural, real-world setting. The novel design and rural setting of the study can contribute much needed evidence to better understand sun exposure and protection, as well as factors determining vaccine effectiveness in rural Africa, and inform the design of immunisation programmes. (TRN PACTCR201611001881114, 24 November 2016, retrospective registration)en_ZA
dc.description.departmentGeography, Geoinformatics and Meteorologyen_ZA
dc.description.librarianam2017en_ZA
dc.description.urihttp://www.biomedcentral.com/bmcpublichealthen_ZA
dc.identifier.citationWright, CY, Albers, PN, Mathee, A, Kunene, Z, D’Este, C, Swaminathan, A & Lucas, RM 2016, 'Sun protection to improve vaccine effectiveness in children in a high ambient ultraviolet radiation and rural environment : an intervention study', BMC Public Health, vol. 17, art. no. 37, pp. 1-8.en_ZA
dc.identifier.issn1471-2458
dc.identifier.other10.1186/s12889-016-3966-0
dc.identifier.urihttp://hdl.handle.net/2263/58773
dc.language.isoenen_ZA
dc.publisherBioMed Centralen_ZA
dc.rights© The Author(s). 2017. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License.en_ZA
dc.subjectImmunisationen_ZA
dc.subjectVaccinationen_ZA
dc.subjectSun exposureen_ZA
dc.subjectMeaslesen_ZA
dc.subjectIntervention studyen_ZA
dc.subjectAfricaen_ZA
dc.subjectUltraviolet (UV)en_ZA
dc.titleSun protection to improve vaccine effectiveness in children in a high ambient ultraviolet radiation and rural environment : an intervention studyen_ZA
dc.typeArticleen_ZA

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