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Abstract
BackgroundMalaria and schistosomiasis represent two of the most prevalent and disabling parasitic infections in developing countries. Few studies have evaluated the effect of maternal schistosomiasis and malaria in the peri-conceptional period on infant’s risk of infection.MethodsIn Benin, women were followed from the preconception period until delivery. Subsequently, their children were followed from birth to 3 months of age. Pre-pregnancy malaria, malaria in pregnancy (MiP)—determined monthly using a thick blood smear—and urinary schistosomiasis—determined once before pregnancy and once at delivery using urine filtration—were the main maternal exposures. Infant’s febrile infection (fever with respiratory, gastrointestinal and/or cutaneous clinical signs anytime during follow-up) was the main outcome. In a secondary analysis, we checked the relation of malaria and schistosomiasis with infant’s hemoglobin (Hb) concentration. Both effects were separately assessed using logistic/mixed linear regression models.ResultsThe prevalence of MiP was 35.7% with 10.8% occurring during the 1st trimester, and the prevalence of schistosomiasis was 21.8%. From birth to 3 months, 25.3% of infants had at least one episode of febrile infection. In multivariate analysis, MiP, particularly malaria in the 1st trimester, was significantly associated with a higher risk of infant’s febrile infection (aOR = 4.99 [1.1; 22.6], p = 0.03). In secondary results, pre-pregnancy malaria and schistosomiasis were significantly associated with a lower infant’s Hb concentration during the first 3 months.ConclusionWe evidenced the deleterious effect of maternal parasitic infections on infant’s health. Our results argue in favor of the implementation of preventive strategies as early as in the peri-conception.
Highlights
According to the Developmental Origins of Health and Diseases (DOHaD) concept, a deleterious environment during peri-conception, gestation and the early postnatal period could lead to a predisposition to childhood and adult-onset diseases [1]
The prevalence of Malaria in pregnancy (MiP) was 35.7% with 10.8% occurring during the 1st trimester, and the prevalence of schistosomiasis was 21.8%
MiP, malaria in the 1st trimester, was significantly associated with a higher risk of infant’s febrile infection
Summary
According to the Developmental Origins of Health and Diseases (DOHaD) concept, a deleterious environment during peri-conception, gestation and the early postnatal period could lead to a predisposition to childhood and adult-onset diseases [1]. In addition to its well-known effects on maternal anemia and low birthweight, MiP has been associated with an enhanced susceptibility to malaria as well as to other infections in infancy [8,9,10]. In these studies, MiP mainly referred to malaria at delivery, none of them assessed the effect of malaria before conception or in early pregnancy on infant’s health. Few studies have evaluated the effect of maternal schistosomiasis and malaria in the peri-conceptional period on infant’s risk of infection
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