Un essai clinique randomis\u00e9 men\u00e9 au Nigeria et publi\u00e9 dans la revue scientifique Nature Medicine analyse l\u2019impact d\u2019une nouvelle modalit\u00e9 d\u2019organisation des soins pr\u00e9ventifs, dite strat\u00e9gie \u00ab NutriVax \u00bb, sur la vaccination des jeunes enfants dans un contexte de forte sous-nutrition et de faibles couvertures vaccinales. L\u2019\u00e9tude porte sur des enfants de 6 \u00e0 23 mois suivis dans des centres de sant\u00e9 primaires de l\u2019\u00c9tat de Yobe, au nord du Nigeria, une zone caract\u00e9ris\u00e9e par une grande ins\u00e9curit\u00e9 alimentaire et une situation s\u00e9curitaire instable. Le Nigeria pr\u00e9sente l\u2019un des taux de mortalit\u00e9 des moins de 5 ans les plus \u00e9lev\u00e9s au monde (105 d\u00e9c\u00e8s pour 1 000 naissances vivantes), tr\u00e8s au-dessus de la cible de 25 pour 1 000 fix\u00e9e par les Objectifs de d\u00e9veloppement durable (ODD) pour 2030.<\/p>\n
Les travaux soulignent le cercle vicieux entre sous-nutrition (incluant malnutrition aigu\u00eb et retard de croissance) et maladies infectieuses dans les contextes de faible couverture vaccinale : les infections r\u00e9duisent les apports alimentaires et favorisent la sous-nutrition, tandis que la sous-nutrition affaiblit le syst\u00e8me immunitaire et augmente la fr\u00e9quence et la gravit\u00e9 des infections. Ce m\u00e9canisme est pr\u00e9sent\u00e9 comme l\u2019une des principales causes de mortalit\u00e9 des enfants de moins de 5 ans, en particulier en Afrique subsaharienne.<\/p>\n
Pour r\u00e9pondre \u00e0 ce double enjeu de sant\u00e9 publique, la strat\u00e9gie NutriVax consiste \u00e0 coupler, au sein des centres de sant\u00e9 primaires, la vaccination de routine avec une distribution mensuelle de suppl\u00e9ments nutritionnels pr\u00e9ventifs de la sous-nutrition. Il s\u2019agit de suppl\u00e9ments nutritionnels \u00e0 base de lipides, en petites quantit\u00e9s et pr\u00eats \u00e0 l\u2019emploi (SQ-LNS), distribu\u00e9s le jour des activit\u00e9s de vaccination, afin d\u2019inciter les familles \u00e0 fr\u00e9quenter r\u00e9guli\u00e8rement les structures de soins. Selon les r\u00e9sultats rapport\u00e9s, cette organisation permet de multiplier par deux la couverture vaccinale contre la rougeole et de diviser par deux la proportion d\u2019enfants n\u2019ayant re\u00e7u aucun vaccin.<\/p>\n
L\u2019\u00e9tude est conduite par un consortium incluant des chercheurs du Centre de Recherche Bordeaux Population Health (Inserm, IRD, universit\u00e9 de Bordeaux), du centre de recherche PAC-CI \u00e0 Abidjan (C\u00f4te d\u2019Ivoire), membre de la Plateforme de Recherche Internationale en Sant\u00e9 Mondiale \u2013 PRISME C\u00f4te d\u2019Ivoire, du Yobe State University Teaching Hospital (Nigeria), ainsi que des \u00e9quipes humanitaires de l\u2019ONG m\u00e9dicale internationale d\u2019urgence ALIMA (The Alliance for International Medical Action). Elle illustre une collaboration entre institutions de recherche fran\u00e7aises et africaines et une ONG internationale autour d\u2019un dispositif int\u00e9grant nutrition et vaccination dans les soins de sant\u00e9 primaires, avec des effets mesurables sur la couverture vaccinale dans un contexte de tr\u00e8s forte vuln\u00e9rabilit\u00e9.\u00a0(contenu r\u00e9sum\u00e9 par l’IA)\u200bLire la Suite<\/a>\u200b<\/p>","protected":false},"excerpt":{"rendered":" Un essai clinique randomis\u00e9 men\u00e9 au Nigeria et publi\u00e9 dans la revue scientifique Nature Medicine analyse l\u2019impact d\u2019une nouvelle modalit\u00e9 d\u2019organisation des soins pr\u00e9ventifs, dite strat\u00e9gie \u00ab NutriVax \u00bb, sur 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