Gino Agbota 1 , 2 , * , Katja Polman 3 , 4 , Frank T. Wieringa 5 , Maiza Campos-Ponce 4 , Manfred Accrombessi 1 , Emmanuel Yovo 1 , Clémentine Roucher 3 , Sem Ezinmègnon 6 , 7 , Javier Yugueros Marcos 6 , Laurence Vachot 6 , Pierre Tissières 7 , Achille Massougbodji 2 , Nadine Fievet 1 , Michel Cot 1 , Valérie Briand 1
19 September 2019
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 1 st 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 1 st 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.