Browsing by Author "Elliott, Alison M."

Now showing 1 - 3 of 3

Effect of Praziquantel Treatment during Pregnancy on Cytokine Responses to Schistosome Antigens: Results of a Randomized, Placebo-Controlled Trial
(Infectious Diseases Society of America, 2008) Tweyongyere, Robert; Mawa, Patrice A; Ngom-wegi, Sophy; Ndibazza, Juliet; Duong, Trinh; Vennervald, Birgitte J.; Dunne, David W; Katunguka-Rwakishaya, Eli; Elliott, Alison M.
Praziquantel treatment of schistosomiasis boosts antischistosome responses, with type 2 helper T cell bias that may contribute to immunologically mediated killing and to protection against reinfection. Praziquantel treatment during pregnancy was recommended in 2002, but the immunological effects of the treatment had not been investigated. A cohort of 387 Schistosoma mansoni–infected women were recruited from a larger trial of deworming during pregnancy. Women were randomized to receive either praziquantel or placebo during pregnancy. Six weeks after delivery, all women received praziquantel. Cytokine responses to S. mansoni worm and egg antigens were measured in whole blood culture before and 6 weeks after each treatment. Schistosome-specific cytokine responses were suppressed during pregnancy. Praziquantel treatment during pregnancy caused significant boosts in interferon-_ (IFN-_), interleukin (IL)–2, IL-4, IL-5, IL-13, and IL-10 responses to schistosome worm antigen and in IFN-_, IL-5, and IL-13 responses to schistosome egg antigen, but these boosts were not as substantial as those seen for women treated after delivery. Pregnancy suppresses a potentially beneficial boost in cytokine responses associated with praziquantel treatment. Further studies are needed on the long-term effects that treatment of schistosomiasis during pregnancy have on morbidity and resistance to reinfection among treated women and their offspring. International Standard Randomized Controlled Trial Number for the parent study: ISRCTN32849447.
Impact of Anthelminthic Treatment in Pregnancy and Childhood on Immunisations, Infections and Eczema in Childhood: A Randomised Controlled Trial
(Uganda Martyrs University, 2012) Ndibazza, Juliet; Mpairwe, Harriet; Webb, Emily L.; Mawa, Patrice A.; Nampijja, Margaret; Muhang, Lawrence; Kihembo, Macklyn; Lule, Swaib A.; Rutebarika, Diana; Apule, Barbara; Akello, Florence; Akurut, Hellen; Oduru, Gloria; Naniima, Peter; Kizito, Dennison; Kizza, Moses; Kizindo, Robert; Tweyongere, Robert; Alcock, Katherine J.; Muwanga, Moses; Elliott, Alison M.
Background: Helminth infections may modulate immune responses to unrelated pathogens and allergens; these effects may commence prenatally. We addressed the hypothesis that anthelminthic treatment in pregnancy and early childhood would improve responses to immunisation and modulate disease incidence in early childhood with both beneficial and detrimental effects. A randomised, double-blind, placebo-controlled trial was conducted in Entebbe, Uganda[ISRCTN32849447]. In three independent randomisations, 2507 pregnant women were allocated to receive single-dose albendazole or placebo, and praziquantel or placebo; 2016 of their offspring were randomised to receive quarterly singledose albendazole or placebo from age 15 months to 5 years. Primary outcomes were post-immunisation recall responses to BCG and tetanus antigens, and incidence of malaria, diarrhoea, and pneumonia; incidence of eczema was an important secondary outcome. Analysis was by intention-to-treat. Of 2345 live births, 1622 (69%) children remained in follow-up at age 5 years. 68% of mothers at enrolment, and 11% of five-year-olds, had helminth infections. Maternal hookworm and Schistosoma mansoni were effectively treated by albendazole and praziquantel, respectively; and childhood hookworm and Ascaris by quarterly albendazole. Incidence rates of malaria, diarrhoea, pneumonia, and eczema were 34, 65, 10 and 5 per 100 py, respectively. Albendazole during pregnancy caused an increased rate of eczema in the children (HR 1.58 (95% CI 1.15–2.17), p = 0.005). Quarterly albendazole during childhood was associated with reduced incidence of clinical malaria (HR 0.85 (95% CI 0.73–0.98), p = 0.03). There were no consistent effects of the interventions on any other outcome. Routine use of albendazole in pregnancy may not always be beneficial, even in tropical developing countries.By contrast, regular albendazole treatment in preschool children may have an additional benefit for malaria control wherehelminths and malaria are co-endemic. Given the low helminth prevalence in our children, the effect of albendazole on malaria is likely to be direct.
Maternal Recall of Birthweight and Birth Size in Entebbe, Uganda
(2012) Ndibazza, Juliet; Lule, Swaib A.; Webb, Emily L.; Nampijja, Margaret; Muhangi, Lawrence; Akello, Florence; Kakande, Muhammed; Kizindo, Robert; Elliott, Alison M.
To assess the reliability of maternally recalled birthweight and size in Entebbe, Uganda.methodsThe study population comprised 404 mothers, who were participants in the Entebbe Motherand Baby Study (EMaBS). Mothers were recruited to EMaBS during antenatal care, maternal charac-teristics were recorded during pregnancy, and birthweight was recorded at delivery. Four to seven yearsafter delivery, mothers were asked to recall the child’s birthweight and size. Their responses werecompared with the birthweight recorded in the EMaBS database.resultsOf 404 interviewed mothers, 303 (75%) were able to give an estimate of birthweight and for265 of these EMaBS data on recorded birthweights were available. Women who were educated andwhose children had low birth order were more likely to be able to give an estimate: 37 (14%) recalled theexact recorded birthweight; a further 52 (20%) were accurate to within 0.1 kg of the recordedweight. On average, mothers overestimated birthweight by 0.06 kg (95% CI: 0.00–0.13 kg,P= 0.04).Recalled and recorded birthweights showed moderate agreement with an intraclass correlation coefficient of0.64. Four hundered mothers gave an estimate of birth size: the sensitivity and specificity of recalled birth sizefor classifying low birthweight were 76% (95% CI: 50–93%) and 70% (95% CI: 65–75%), respectively.conclusionsMothers’ recall of birthweight was not precise but in absence of other data, recall ofbirthweight and size may have some value in epidemiological studies in these settings.