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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Maternal hookworm modifies risk factors for childhood eczema: Results from a birth cohort in Uganda
Pediatric Allergy and Immunology, Volume 25, No. 5, Year 2014
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Description
Background: Worms may protect against allergy. Early-life worm exposure may be critical, but this has not been fully investigated. Objectives: To investigate whether worms in pregnancy and in early childhood are associated with childhood eczema incidence. Methods: The Entebbe Mother and Baby Study, an anthelminthic treatment trial, enrolled pregnant women between 2003 and 2005 in Uganda. Mothers were investigated for worms during pregnancy and children annually. Eczema was doctor-diagnosed from birth to age five years. A planned observational analysis was conducted within the trial cohort to investigate associations between worms and eczema. Results: Data for 2345 live-born children were analysed. Hookworm was the most prevalent maternal worm (45%). Childhood worms were less prevalent. Eczema incidence was 4.68/100 person-years. Maternal hookworm was associated with reduced eczema incidence [adjusted hazard ratio (95% confidence interval), p-value: 0.71(0.51-0.99), 0.04] and modified effects of known risk factors for eczema: Dermatophagoides-specific IgE in children was positively associated with eczema incidence if the mother had no hookworm [2.72(1.11-6.63), 0.03], but not if the mother had hookworm [0.41(0.10-1.69), 0.22], interaction p-value = 0.03. Similar interactions were seen for maternal history of eczema {[2.87(1.31-6.27, 0.008) vs. [0.73(0.23-2.30), 0.60], interaction p-value = 0.05}, female gender {[1.82(1.22-2.73), 0.004 vs. [0.96(0.60-1.53), 0.87], interaction p-value = 0.04} and allergen-specific IgE. Childhood Trichuris trichiura and hookworm were inversely associated with eczema. Conclusions: Maternal hookworm modifies effects of known risk factors for eczema. Mechanisms by which early-life worm exposures influence allergy need investigation. Worms or worm products, and intervention during pregnancy have potential for primary prevention of allergy. © 2014 The Authors.
Authors & Co-Authors
Mpairwe, Harriet
Unknown Affiliation
Ndibazza, Juliet
Unknown Affiliation
Webb, Emily L.
Unknown Affiliation
Nampijja, Margaret
Unknown Affiliation
Muhangi, Lawrence
Unknown Affiliation
Apule, B.
Unknown Affiliation
Lule, Swaib A.
Unknown Affiliation
Akurut, Helen
Unknown Affiliation
Kizito, Dennison
Unknown Affiliation
Kakande, Mohammed
Unknown Affiliation
Jones, Frances M.
Unknown Affiliation
Fitzsimmons, Colin Matthew
Unknown Affiliation
Muwanga, Moses
Unknown Affiliation
Rodrigues, Laura Cunha
Unknown Affiliation
Dunne, David William
Unknown Affiliation
Elliott, Alison M.
Unknown Affiliation
Statistics
Citations: 47
Authors: 16
Affiliations: 5
Identifiers
Doi:
10.1111/pai.12251
ISSN:
09056157
e-ISSN:
13993038
Research Areas
Environmental
Health System And Policy
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Cohort Study
Study Locations
Uganda
Participants Gender
Female