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Cited by 125Parasites and Host InteractionsParasitic Diseases Research and TreatmentChild Nutrition and Water Access

The impact of helminths on the response to immunization and on the incidence of infection and disease in childhood in Uganda: design of a randomized, double-blind, placebo-controlled, factorial trial of deworming interventions delivered in pregnancy and early childhood [ISRCTN32849447]

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Elliott, Alison M, Kizza, Moses, Quigley, Maria A, Ndibazza, Juliet, Nampijja, Margaret, Muhangi, Lawrence, Morison, Linda, Namujju, Proscovia B +3 more·2007·Clinical Trials
DOI 10.1177/1740774506075248PMC PMC2643383
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Abstract

Background Helminths have profound effects on the immune response, allowing long-term survival of parasites with minimal damage to the host. Some of these effects “spill-over”, altering responses to non-helminth antigens or allergens. It is suggested that this may lead to impaired responses to immunizations and infections, while conferring benefits against inflammatory responses in allergic and autoimmune disease. These effects might develop in utero, through exposure to maternal helminth infections, or through direct exposure in later life. Purpose To determine the effects of helminths and their treatment in pregnancy and in young children on immunological and disease outcomes in childhood. Methods The trial has three randomized, double-blind, placebo-controlled interventions at two times, in two people: a pregnant woman and her child. Pregnant women are randomized to albendazole or placebo and praziquantel or placebo. At age 15 months their children are randomized to three-monthly albendazole or placebo, to continue to age five years. The proposed designation for this sequence of interventions is a 2 × 2(×2) factorial design. Children are immunized with BCG and against polio, Diphtheria, tetanus, Pertussis, Haemophilus, hepatitis B and measles. Primary immunological outcomes are responses to BCG antigens and tetanus toxoid in whole blood cytokine assays and antibody assays at one, three and five years of age. Primary disease outcomes are incidence of malaria, pneumonia, diarrhoea, tuberculosis, measles, vertical HIV transmission, and atopic disease episodes, measured at clinic visits and twice-monthly home visits. Effects on anaemia, growth and intellectual development are also assessed. Conclusion This trial, with a novel design comprising related interventions in pregnant women and their offspring, is the first to examine effects of helminths and their treatment in pregnancy and early childhood on immunological, infectious disease and allergic disease outcomes. The results will enhance understanding of both detrimental and beneficial effects of helminth infection and inform policy.

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  • The rate of eczema in such countries was found to be about five times higher in infants whose mothers had never had helminths compared with persistent helminth-infected mothers.

    “The rate of eczema in such countries was found to be about five times higher in infants whose mothers had never had helminths compared with persistent helminth-infected mothers [232,233].”

    From A One Health Perspective on the Human-Companion Animal Relationship with Emphasis on Zoonotic Aspects. (2020) · cites this paper as [232]

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Authors
Elliott, A. M., Kizza, M., Quigley, M. A., Ndibazza, J., Nampijja, M., Muhangi, L., Morison, L., Namujju, P. B., Muwanga, M., Kabatereine, N., & Whitwortha, J. A.
Affiliations
  • London School of Hygiene & Tropical Medicine (GB)
  • Uganda Virus Research Institute (UG)
  • University of Oxford (GB)
  • Entebbe Hospital, Entebbe, Uganda
  • Ministry of Health (UG)
Corresponding author
Elliott, Alison M
ORCID
Venue
Clinical Trials
Publisher
SAGE Publications
Published
2007-02
Volume
4
Issue
1
Pages
42-57
ISSN
  • 1740-7745 (ISSN-L)
  • 1740-7753
DOI
10.1177/1740774506075248
PMC
PMC2643383
OpenAlex
W2054445248
Cited by
125
References
1
Citations by year
2026: 2 · 2025: 1 · 2023: 1 · 2022: 3 · 2021: 20 · 2020: 8 · 2019: 7 · 2018: 7 · 2017: 8 · 2016: 5 · 2015: 6 · 2014: 8 · 2013: 8 · 2012: 10
FWCI
5.35
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Trials (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • Open Research (University of Surrey) (submittedVersion)
  • Surrey Research Insight Open Access (The University of Surrey) (submittedVersion)
Funders
  • GlaxoSmithKline
  • Wellcome Trust (064693)
  • Medical Research Council
Topics
  • Life Sciences › Immunology and Microbiology › Parasitology › Parasites and Host Interactions
  • Health Sciences › Medicine › Infectious Diseases › Parasitic Diseases Research and Treatment
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
Keywords
helminthiasis, anthelmintic treatment, albendazole, praziquantel, pregnancy, early childhood, immunization response, BCG vaccine, tetanus toxoid, cytokine response, antibody response, malaria, pneumonia, diarrhea, tuberculosis, measles, perinatal HIV transmission, atopic diseases, anemia, child growth, intellectual development, Uganda
MeSH terms
Animals, Antiparasitic Agents, Child, Double-Blind Method, Female, Helminthiasis, Helminths, Humans, Immunization, Male, Praziquantel, Pregnancy, Research Design, Uganda, Pregnancy Complications, Parasitic, Albendazole, Incidence

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