Treatment with anthelminthics during pregnancy: what gains and what risks for the mother and child?


Elliott, AM; Ndibazza, J; Mpairwe, H; Muhangi, L; Webb, EL; Kizito, D; Mawa, P; Tweyongyere, R; Muwanga, M; (2011) Treatment with anthelminthics during pregnancy: what gains and what risks for the mother and child? Parasitology, 138 (12). pp. 1499-507. ISSN 0031-1820 DOI: https://doi.org/10.1017/S0031182011001053

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Abstract

In 1994 and 2002, respectively, the World Health Organisation proposed that treatment for hookworm and schistosomiasis could be provided during pregnancy. It was hoped that this might have benefits for maternal anaemia, fetal growth and perinatal mortality; a beneficial effect on the infant response to immunisation was also hypothesised. Three trials have now been conducted. Two have examined the effects of benzimidazoles; one (the Entebbe Mother and Baby Study) the effects of albendazole and praziquantel. All three were conducted in settings of high prevalence but low intensity helminth infection. Results suggest that, in such settings and given adequate provision of haematinics, the benefit of routine anthelminthics during pregnancy for maternal anaemia may be small; none of the other expected benefits has yet been demonstrated. The Entebbe Mother and Baby Study found a significant adverse effect of albendazole on the incidence of infantile eczema in the whole study population, and of praziquantel on the incidence of eczema among infants of mothers with Schistosoma mansoni. Further studies are required in settings that differ in helminth species and infection intensities. Further research is required to determine whether increased rates of infantile eczema translate to long-term susceptibility to allergy, and to explore the underlying mechanisms of these effects. The risks and benefits of routine anthelminthic treatment in antenatal clinics may need to be reconsidered.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
Neglected Tropical Diseases Network
Tropical Epidemiology Group
PubMed ID: 21810307
Web of Science ID: 295970000007
URI: http://researchonline.lshtm.ac.uk/id/eprint/18544

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