Maternal malaria but not schistosomiasis is associated with a higher risk of febrile infection in infant during the first 3 months of life: A mother-child cohort in Benin

• Published in: PloS one Vol. 14; no. 9; p. e0222864
• Main Authors: Agbota, Gino, Polman, Katja, Wieringa, Frank T, Campos-Ponce, Maiza, Accrombessi, Manfred, Yovo, Emmanuel, Roucher, Clémentine, Ezinmègnon, Sem, Marcos, Javier Yugueros, Vachot, Laurence, Tissières, Pierre, Massougbodji, Achille, Fievet, Nadine, Cot, Michel, Briand, Valérie
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 19.09.2019; Public Library of Science (PLoS)
• Subjects: Adolescent; Adult; Anemia; Babies; Benin - epidemiology; Birth; Breastfeeding & lactation; Care and treatment; Cohort Studies; Complications and side effects; Developing countries; Febrile seizures; Female; Fever; Fever - epidemiology; Fever - parasitology; Fever - physiopathology; Glycosylated hemoglobin; Health aspects; Health risks; Health sciences; Hemoglobin; Hemoglobins; Humans; Infant; Infant, Newborn; Infants; Infection; Infections; Infectious diseases; LDCs; Life Sciences; Logistic Models; Malaria; Malaria - epidemiology; Malaria - parasitology; Malaria - physiopathology; Malnutrition; Medical research; Medicine and Health Sciences; Mothers; Multivariate Analysis; Parasitic diseases; People and Places; Pregnancy; Pregnancy Complications, Parasitic - epidemiology; Pregnancy Complications, Parasitic - physiopathology; Pregnancy Trimester, First - physiology; Prevalence; Regression analysis; Regression models; Risk; Risk Factors; Schistosomiasis; Schistosomiasis - epidemiology; Schistosomiasis - parasitology; Schistosomiasis - physiopathology; Secondary analysis; Sepsis; Tropical diseases; Ultrasonic imaging; Urine; Vector-borne diseases; Womens health; Young Adult; Benin; Netherlands; Belgium; France
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0222864

Malaria 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. In 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. The 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. We 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.