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Complex Interactions between Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border

BACKGROUND: Deworming is recommended by the WHO in girls and pregnant and lactating women to reduce anaemia in areas where hookworm and anaemia are common. There is conflicting evidence on the harm and the benefits of intestinal geohelminth infections on the incidence and severity of malaria, and co...

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Autores principales: Boel, Machteld, Carrara, Verena I., Rijken, Marcus, Proux, Stephane, Nacher, Mathieu, Pimanpanarak, Mupawjay, Paw, Moo Koo, Moo, Oh, Gay, Hser, Bailey, Wendi, Singhasivanon, Pratap, White, Nicholas J., Nosten, François, McGready, Rose
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2982827/
https://www.ncbi.nlm.nih.gov/pubmed/21103367
http://dx.doi.org/10.1371/journal.pntd.0000887
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author Boel, Machteld
Carrara, Verena I.
Rijken, Marcus
Proux, Stephane
Nacher, Mathieu
Pimanpanarak, Mupawjay
Paw, Moo Koo
Moo, Oh
Gay, Hser
Bailey, Wendi
Singhasivanon, Pratap
White, Nicholas J.
Nosten, François
McGready, Rose
author_facet Boel, Machteld
Carrara, Verena I.
Rijken, Marcus
Proux, Stephane
Nacher, Mathieu
Pimanpanarak, Mupawjay
Paw, Moo Koo
Moo, Oh
Gay, Hser
Bailey, Wendi
Singhasivanon, Pratap
White, Nicholas J.
Nosten, François
McGready, Rose
author_sort Boel, Machteld
collection PubMed
description BACKGROUND: Deworming is recommended by the WHO in girls and pregnant and lactating women to reduce anaemia in areas where hookworm and anaemia are common. There is conflicting evidence on the harm and the benefits of intestinal geohelminth infections on the incidence and severity of malaria, and consequently on the risks and benefits of deworming in malaria affected populations. We examined the association between geohelminths and malaria in pregnancy on the Thai-Burmese border. METHODOLOGY: Routine antenatal care (ANC) included active detection of malaria (weekly blood smear) and anaemia (second weekly haematocrit) and systematic reporting of birth outcomes. In 1996 stool samples were collected in cross sectional surveys from women attending the ANCs. This was repeated in 2007 when malaria incidence had reduced considerably. The relationship between geohelminth infection and the progress and outcome of pregnancy was assessed. PRINCIPAL FINDINGS: Stool sample examination (339 in 1996, 490 in 2007) detected a high prevalence of geohelminths 70% (578/829), including hookworm (42.8% (355)), A. lumbricoides (34.4% (285)) and T.trichuria (31.4% (250)) alone or in combination. A lower proportion of women (829) had mild (21.8% (181)) or severe (0.2% (2)) anaemia, or malaria 22.4% (186) (P.vivax monoinfection 53.3% (101/186)). A. lumbricoides infection was associated with a significantly decreased risk of malaria (any species) (AOR: 0.43, 95% CI: 0.23–0.84) and P.vivax malaria (AOR: 0.29, 95% CI: 0.11–0.79) whereas hookworm infection was associated with an increased risk of malaria (any species) (AOR: 1.66, 95% CI: 1.06–2.60) and anaemia (AOR: 2.41, 95% CI: 1.18–4.93). Hookworm was also associated with low birth weight (AOR: 1.81, 95% CI: 1.02–3.23). CONCLUSION/SIGNIFICANCE: A. lumbricoides and hookworm appear to have contrary associations with malaria in pregnancy.
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spelling pubmed-29828272010-11-22 Complex Interactions between Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border Boel, Machteld Carrara, Verena I. Rijken, Marcus Proux, Stephane Nacher, Mathieu Pimanpanarak, Mupawjay Paw, Moo Koo Moo, Oh Gay, Hser Bailey, Wendi Singhasivanon, Pratap White, Nicholas J. Nosten, François McGready, Rose PLoS Negl Trop Dis Research Article BACKGROUND: Deworming is recommended by the WHO in girls and pregnant and lactating women to reduce anaemia in areas where hookworm and anaemia are common. There is conflicting evidence on the harm and the benefits of intestinal geohelminth infections on the incidence and severity of malaria, and consequently on the risks and benefits of deworming in malaria affected populations. We examined the association between geohelminths and malaria in pregnancy on the Thai-Burmese border. METHODOLOGY: Routine antenatal care (ANC) included active detection of malaria (weekly blood smear) and anaemia (second weekly haematocrit) and systematic reporting of birth outcomes. In 1996 stool samples were collected in cross sectional surveys from women attending the ANCs. This was repeated in 2007 when malaria incidence had reduced considerably. The relationship between geohelminth infection and the progress and outcome of pregnancy was assessed. PRINCIPAL FINDINGS: Stool sample examination (339 in 1996, 490 in 2007) detected a high prevalence of geohelminths 70% (578/829), including hookworm (42.8% (355)), A. lumbricoides (34.4% (285)) and T.trichuria (31.4% (250)) alone or in combination. A lower proportion of women (829) had mild (21.8% (181)) or severe (0.2% (2)) anaemia, or malaria 22.4% (186) (P.vivax monoinfection 53.3% (101/186)). A. lumbricoides infection was associated with a significantly decreased risk of malaria (any species) (AOR: 0.43, 95% CI: 0.23–0.84) and P.vivax malaria (AOR: 0.29, 95% CI: 0.11–0.79) whereas hookworm infection was associated with an increased risk of malaria (any species) (AOR: 1.66, 95% CI: 1.06–2.60) and anaemia (AOR: 2.41, 95% CI: 1.18–4.93). Hookworm was also associated with low birth weight (AOR: 1.81, 95% CI: 1.02–3.23). CONCLUSION/SIGNIFICANCE: A. lumbricoides and hookworm appear to have contrary associations with malaria in pregnancy. Public Library of Science 2010-11-16 /pmc/articles/PMC2982827/ /pubmed/21103367 http://dx.doi.org/10.1371/journal.pntd.0000887 Text en Boel et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Boel, Machteld
Carrara, Verena I.
Rijken, Marcus
Proux, Stephane
Nacher, Mathieu
Pimanpanarak, Mupawjay
Paw, Moo Koo
Moo, Oh
Gay, Hser
Bailey, Wendi
Singhasivanon, Pratap
White, Nicholas J.
Nosten, François
McGready, Rose
Complex Interactions between Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border
title Complex Interactions between Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border
title_full Complex Interactions between Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border
title_fullStr Complex Interactions between Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border
title_full_unstemmed Complex Interactions between Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border
title_short Complex Interactions between Soil-Transmitted Helminths and Malaria in Pregnant Women on the Thai-Burmese Border
title_sort complex interactions between soil-transmitted helminths and malaria in pregnant women on the thai-burmese border
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2982827/
https://www.ncbi.nlm.nih.gov/pubmed/21103367
http://dx.doi.org/10.1371/journal.pntd.0000887
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