Parasitology

  • Parasitology / Volume 138 / Special Issue 12 / October 2011, pp 1499-1507
  • Copyright © Cambridge University Press 2011. The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence <http://creativecommons.org/licenses/by-nc-sa/2.5/>. The written permission of Cambridge University Press must be obtained for commercial re-use.
  • DOI: http://dx.doi.org/10.1017/S0031182011001053 (About DOI), Published online: 03 August 2011
  • OPEN ACCESS

Research Article

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

ALISON M. ELLIOTTa1a2 c1, JULIET NDIBAZZAa1, HARRIET MPAIRWEa1, LAWRENCE MUHANGIa1, EMILY L. WEBBa2, DENNISON KIZITOa1, PATRICE MAWAa1, ROBERT TWEYONGYEREa3 and MOSES MUWANGAa4 for the ENTEBBE MOTHER AND BABY STUDY TEAM

a1 MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, PO Box 49, Entebbe, Uganda

a2 London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK

a3 Faculty of Veterinary Medicine, Makerere University, Kampala, Uganda

a4 Entebbe Hospital, PO Box 29, Entebbe, Uganda

SUMMARY

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.

(Received December 07 2010)

(Revised April 22 2011)

(Accepted June 11 2011)

(Online publication August 03 2011)

Correspondence:

c1 Corresponding author: Alison M. Elliott, MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda. Tel: +256 752 720609; Fax: +256 414 321137; E-mail: alison.tom@infocom.co.ug

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