Maternal hookworm modifies risk factors for childhood eczema: results from a birth cohort in Uganda

dc.contributor.authorMpairwe, Harriet
dc.contributor.authorNdibazza, Juliet
dc.contributor.authorWebb, Emily L
dc.contributor.authorNampijja, Margaret
dc.contributor.authorMuhangi, Lawrence
dc.contributor.authorApule, Barbara
dc.contributor.authorLule, Swaib
dc.contributor.authorAkurut, Helen
dc.contributor.authorKizito, Dennison
dc.contributor.authorKakande, Mohammed
dc.contributor.authorJones, Frances M
dc.contributor.authorFitzsimmons, Colin M.
dc.contributor.authorMuwanga, Moses
dc.contributor.authorRodrigues, Laura C.
dc.contributor.authorDunne, David W
dc.contributor.authorElliott, Alison M
dc.date.accessioned2018-07-26T08:41:07Z
dc.date.available2018-07-26T08:41:07Z
dc.date.issued2014
dc.description.abstractBackground: Worms may protect against allergy. Early-life worm exposure may be critical, but this has not been fully investigated. Objectives: To investigate whether worms in pregnancy and in early childhood are associated with childhood eczema incidence. Methods: The Entebbe Mother and Baby Study, an anthelminthic treatment trial, enrolled pregnant women between 2003 and 2005 in Uganda. Mothers were investigated for worms during pregnancy and children annually. Eczema was doctor-diagnosed from birth to age five years. A planned observational analysis was conducted within the trial cohort to investigate associations between worms and eczema. Results: Data for 2345 live-born children were analysed. Hookworm was the most prevalent maternal worm (45%). Childhood worms were less prevalent. Eczema incidence was 4.68/100 person-years. Maternal hookworm was associated with reduced eczema incidence [adjusted hazard ratio (95% confidence interval), p-value: 0.71(0.51–0.99), 0.04] and modified effects of known risk factors for eczema: Dermatophagoides-specific IgE in children was positively associated with eczema incidence if the mother had no hookworm [2.72(1.11–6.63), 0.03], but not if the mother had hookworm [0.41(0.10–1.69), 0.22], interaction p-value = 0.03. Similar interactions were seen for maternal history of eczema {[2.87(1.31–6.27, 0.008) vs. [0.73(0.23–2.30), 0.60], interaction p-value = 0.05}, female gender {[1.82(1.22–2.73), 0.004 vs. [0.96 (0.60–1.53), 0.87], interaction p-value = 0.04} and allergen-specific IgE. Childhood Trichuris trichiura and hookworm were inversely associated with eczema. Conclusions: Maternal hookworm modifies effects of known risk factors for eczema. Mechanisms by which early-life worm exposures influence allergy need investigation. Worms or worm products, and intervention during pregnancy have potential for primary prevention of allergy.en_US
dc.identifier.otherDOI:10.1111/pai.12251
dc.identifier.urihttp://hdl.handle.net/20.500.12280/550
dc.language.isoenen_US
dc.publisherPediatric Allergy and Immunologyen_US
dc.subjectUgandaen_US
dc.subjectSkin prick testen_US
dc.subjectPregnancyen_US
dc.subjectIncidenceen_US
dc.subjectIgEen_US
dc.subjectHookwormen_US
dc.subjectEffect modificationen_US
dc.subjectEczemaen_US
dc.subjectChildrenen_US
dc.subjectBirth cohorten_US
dc.titleMaternal hookworm modifies risk factors for childhood eczema: results from a birth cohort in Ugandaen_US
dc.typeArticleen_US

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