Associations Between Maternal Helminth and Malaria Infections in Pregnancy and Clinical Malaria in the Offspring: A Birth Cohort in Entebbe, Uganda
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Date
2013
Authors
Ndibazza, Juliet
Webb, Emily L
Lule, Swaib
Mpairwe, Harriet
Akello, Miriam
Oduru, Gloria
Kizza, Moses
Akurut, Helen
Muhangi, Lawrence
Magnussen, Pascal
Journal Title
Journal ISSN
Volume Title
Publisher
Oxford University Press on behalf of the Infectious Diseases Society of America
Abstract
Helminth and malaria coinfections are common in the tropics. We investigated the hypothesis
that prenatal exposure to these parasites might influence susceptibility to malaria in childhood.
Methods. In a birth cohort of 2345 mother–child pairs in Uganda, maternal helminth and malaria infection
status was determined during pregnancy, and childhood malaria episodes were recorded from birth to age 5 years.
We examined associations between maternal infections and malaria in the offspring.
Results. Common maternal infections were hookworm (45%), Mansonella perstans (21%), Schistosoma
mansoni (18%), and Plasmodium falciparum (11%). At age 5 years, 69% of the children were still under follow-up.
The incidence of malaria was 34 episodes per 100 child-years, and the mean prevalence of asymptomatic malaria at
annual visits was 5.4%. Maternal hookworm and M. perstans infections were associated with an increased rate of
childhood clinical malaria (adjusted hazard ratio [aHR], 1.24, 95% confidence interval [CI], 1.10–1.41; aHR, 1.20,
95% CI, 1.05–1.38, respectively). S. mansoni infection had no consistent association with childhood malaria.
Conclusions. This is the first report of an association between helminth infections in pregnancy and malaria in the
offspring and indicates that helminth infections in pregnancy may increase the burden of childhood malaria morbidity.
Description
Keywords
Childhood, Pregnancy, Coinfections, Helminths, Malaria