Maternal postpartum deworming: a novel strategy to reduce infant and maternal morbidity in low-and-middle-income countries
Notice bibliographique
Résumé
Background:The World Health Organization identifies women of reproductive age as a high risk group for soil-transmitted helminth infections because these infections cause blood loss, iron deficiency anemia, and nutritional impairment.Deworming is a central component of control efforts aimed at reducing the burden of disease in endemic areas.The postpartum period offers a unique opportunity to reach women periodically throughout their reproductive lifespans.To date, no study has investigated the effect of maternal postpartum deworming on infant or maternal health outcomes. Objectives:The objectives of this study were to determine the effectiveness of maternal postpartum deworming on the following infant and maternal health outcomes: 1) infant growth and morbidity; 2) maternal soil-transmitted helminth infection and intensity, anemia, and fatigue; and 3) breast milk quality indicators.Methods: A double-blind, randomized, placebo-controlled trial was carried out in Iquitos, Peru.Mother-infant pairs were enrolled into the trial following delivery at Hospital Iquitos "Cesar Garayar Garcia".Prior to hospital discharge women were randomized to receive either a singledose 400 mg albendazole tablet (i.e., deworming) or identical placebo, based on a pre-specified randomization schedule.Mother-infant pairs were visited in their homes at 1 and 6 months postpartum for outcome ascertainment.The primary outcome was mean infant weight gain between birth and 6 months of age.Continuous outcomes were compared between intervention groups using linear regression models and dichotomous outcomes were compared using logbinomial regression models.Analyses followed an intention-to-treat approach.Adjusted, complete-case, and per-protocol analyses were also performed. Results:Between February and August 2014, 1010 mother-infant pairs were enrolled into the trial.A total of 999 (98.9%) and 970 (96.0%) mother-infant pairs completed their 1 and 6-month study visits, respectively.Infant weight gain between birth and 6 months of age was similar between intervention groups (4.3 kg 0.04 vs. 4.4 kg 0.04), as were secondary growth indices.The single-dose deworming intervention also did not have a differential effect on the occurrence ii of hospitalizations, nor on the incidence of diarrhea, respiratory illness, fever, or ear infections in infants.Over the 6-month postpartum period, deworming significantly reduced the prevalence (RR: 0.5; 95% CI: 0.4, 0.6) and intensity of maternal helminth infections but had no demonstrable effect on maternal anemia (RR: 1.0; 95% CI: 0.9, 1.1) or fatigue score (mean difference: -0.4; 95% CI: -1.1, 0.3).Additionally, the mean concentration of vitamins and minerals in breast milk was similar between intervention groups.Conclusions: Overall, while single-dose deworming did reduce maternal helminth infections, no statistically significant benefit was detected on infant growth or morbidity outcomes in the first 6 months of life.Maternal postpartum deworming also had no effect on the prevalence of maternal anemia, fatigue, and breast milk composition.The benefits of deworming may be more apparent in areas of higher prevalence and intensity of soil-transmitted helminth infection, over longer periods of follow-up, and with repeated administration.This first trial on maternal postpartum deworming contributes essential empirical evidence to inform World Health Organization policy and guidelines towards eliminating soil-transmitted helminthiasis as a public health problem.personally.All this would not have been possible without the guidance and encouragement of my supervisor, Dr. Theresa Gyorkos.It is not every day that we encounter a mentor that invests so deeply in the success of their students and pushes them to be the best version of themselves.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».