Pneumococcal protein antigen serology varies with age and may predict antigenic profile of colonizing isolates

BACKGROUND: Several Streptococcus pneumoniae proteins play a role in pathogenesis and are being investigated as vaccine targets. It is largely unknown whether naturallyacquired antibodies reduce the risk of colonization with strains expressing a particular antigenic variant. METHODS: Serum IgG titers to 28 pneumococcal protein antigens were measured among 242 individuals, aged < 6 months - 78 years in Native American communities between 2007-2009. Nasopharyngeal swabs were collected at least 30 days after serum collection, and the protein antigen variant in each pneumococcal isolate was determined using genomic data. We assessed the association between preexisting variant-specific antibody titers and subsequent carriage of pneumococcus expressing a particular antigen variant. RESULTS: Antibody titers often increased across pediatric groups before decreasing among adults. PspA and StkP IgG titers decreased from <6 months to 6-12 months (p<0.01). Individuals with low titers against Group 3 PspC variants were more likely to be colonized with pneumococci expressing those variants. For other antigens, variantspecific IgG titers do not predict colonization with pneumococci expressing particular variants CONCLUSION: We observed an inverse association between variant-specific antibody concentration and homologous pneumococcal colonization for only one protein. Further assessment of antibody repertoires may elucidate the nature of anti-pneumococcal antibody-mediated mucosal immunity while informing future vaccine development

Engaging native American caregivers in youth-focused diabetes prevention and management

Native American youth aged 10 to 19 years are disproportionately affected by type 2 diabetes. Intergenerational programs may improve health in tribal communities. We evaluated Together on Diabetes, a diabetes prevention and management program, among 257 participating Native American youths with or at risk for type 2 diabetes and their adult caregivers. Feasibility, acceptability, and demographic data were collected from 226 adult caregivers. Data on physical measurements (weight, height, waist circumference) were collected from 37 of the caregivers. Results indicated that engaging adult caregivers was feasible, acceptable, and effective. Furthermore, a subset of adult caregivers reduced their body mass index (weight in kilograms divided by height in m2) significantly from the start to the end of the program, a 12 month period (P = .02). Findings suggest the feasibility of engaging adult caregivers in youth diabetes prevention programs

Empowering native adolescents: Responsibility for their health behaviors

Objectives: In this study, we assess the impact of a home-based diabetes prevention program, Together on Diabetes (TOD), on adolescent responsibility-taking for tasks related to diabetes risk. Methods: Participants were Native American youth ages 10-19 with or at risk of type 2 diabetes who participated in a 12-session, 6-month diabetes prevention program with an adult caretaker. Assessments completed at baseline, 6-month, and 12-month follow-up include demographics and the Diabetes and Obesity Task Sharing (DOTS) Questionnaire. We used latent class analysis (LCA) at baseline to examine heterogeneity in DOTS responses. We identified 3 classes (adolescent, shared, caretaker). We used latent transition analysis to examine stability and change in latent status at baseline, 6- and 12-month follow-up. Results: At baseline, the mean age of participants was 13.6 years and 55.9% were boys. From baseline to 6-month follow-up, the adolescent class was most stable, whereas the shared and caretaker classes were less stable. For participants who transition from the adolescent class, most transition to shared class compared to caretaker class. Conclusions: TOD helps to empower Native American adolescents to take responsibility for their health and engage with their caregivers in these decisions

Toward Understanding Suicide Among Youths: Results From the White Mountain Apache Tribally Mandated Suicide Surveillance System, 2001–2006

Objectives. We examined suicide and suicide attempt rates, patterns, and risk factors among White Mountain Apache youths (aged < 25 years) from 2001 to 2006 as the first phase of a community-based participatory research process to design and evaluate suicide prevention interventions