Biomarkers of Inflammation in the Context of Acute Illness among Children 12–24 Months of Age Living in the Urban Slums of Mumbai

To examine and compare the concentration of acute phase proteins, including nutritional and inflammation biomarkers, by morbidity status among children 12–24 months old living in urban slums of Mumbai. 12–24-month-old children were screened for participation in a randomized controlled trial involving feeding of iron- and zinc-biofortified pearl millet complementary foods. Information on acute illness including fever, respiratory symptoms, and diarrhea on the day of screening, in the past 7 days, and the last 4 weeks was collected along with blood samples for analysis of concentrations of nutritional (ferritin, retinol) and inflammation biomarkers (C-reactive protein, alpha-1-glycoprotein) involved in the acute phase response. Difference in medians were compared by the Kruskal-Wallis Test. The mean age of children was 14.9 months; 51% were males. More than half the children (54%) had at least one or more symptoms such as fever, cough, or diarrhea at any timepoint in the 4 weeks prior to the interview. Among those with symptoms, fever and respiratory symptoms, either alone or in combination, were most common (44.8%), while diarrhea (alone or in combination with fever or respiratory symptoms) was present in only 11% of the population. More than a quarter had some illness in the 7 days before the interview (25.8%) with 2.5% having illness (fever and/or respiratory symptoms) on the day of the interview. Among those reporting no morbidity, 7% had elevated CRP. Among those reporting acute illness on the day of interview or in the past 7 days, 13% had elevated CRP. When compared across different kinds of acute illness and having no symptoms, there was no significant difference in the median concentrations of CRP, ferritin, and retinol. Similar results were observed on comparing the concentration of these acute phase reactants across children with no, one, two, or more symptoms. Among this pediatric population, we did not observe any significant difference in the concentration of acute phase reactants by illness type or number of concurrent illnesses compared with apparently healthy children. HarvestPlus.