Browsing by Author "Lule Swaib A."

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    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.
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    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.