| Titre : | Malaria risk factors for pregnant women and infants in Benin |
| Auteurs : | Violeta Moya-Alvarez ; Michel Cot, dir. ; Réseau doctoral en santé publique - EHESP ; ED 393 « École doctorale Pierre Louis de santé publique : épidémiologie et sciences de l’information biomédicale » – UPMC |
| Type de document : | Thèse |
| Année de publication : | 2015 |
| Description : | 240p. / tabl., fig., ann. |
| Langues: | Anglais |
| Classement : | THESE15/ (Thèse soutenue en 2015) |
| Mots-clés : | Paludisme ; Grossesse ; Femme enceinte ; Enfant ; Enfant 2 5 ans ; Risque ; Facteur risque ; Enquête épidémiologique ; Epidémiologie ; Bénin ; Afrique |
| Résumé : | In Benin malaria and nutritional deficiencies are the main diseases contributing to the disease burden. Therefore, preventive strategies targetting both diseases have been deployed for over 10 years. Pregnancy-associated malaria (PAM) is responsible for maternal anaemia, placental malaria and low birth weight (<2500g), contributing to enhance maternal and child morbidity and mortality. To prevent PAM, the World Health Organization recommends the intermittent preventive treatmentduring pregnancy (IPTp). In Benin it consists in the administration of two curative doses of sulfadoxine/pyrimethamine (SP) at least one month apart and starting at the second trimester of pregnancy. Considering that IPTp has an effect on PAM, and thereby influences the exposure of the foetus to the parasite, we wanted to investigate the possible effect of IPTp on malaria in infants. In parallel, iron supplements are recommended during pregnancy to prevent maternal anemia. Some pediatricians give iron supplements to infants as well. As there is some epidemiological evidence that iron might enhance malaria episodes and their severity we wanted to analyse the association of iron levels with malaria in pregnancy and infancy. Therefore, we analysed data from a cohort study of 1005 pregnant women conducted from 2010 to 2012 in Allada (Benin), and data of the first 400 infants born to this cohort of mothers, who were followed for a year. First, we showed that interval length between IPTp doses (the number of days between doses) was inversely correlated with malaria risk and P. falciparum parasitemia, possibly due to the reduction of the exposure of the foetus to the parasite in utero, which thereby hinders a possible immune tolerance process. We also found that iron levels during pregnancy and infancy were associated to increased malaria risk and P. falciparum parasitemia, with a possible dose effect. In a context of growing resistance to SP, a strategy based on more than 2 doses of SP should be encouraged to confer an optimal protection to pregnant women. In addition, complementary interventional data are needed to determine the benefits and risks of differently dosed iron supplements, in order to ascertain their impact on infant health in malaria-endemic regions. (R.A.) |
| Diplôme : | Thèse du réseau doctoral en santé publique animé par l'EHESP |
| Spécialité de la thèse : | Épidémiologie |
| Plan de classement simplifié : | Thèses du réseau doctoral en santé publique animé par l'EHESP |
| En ligne : | http://documentation.ehesp.fr/theses/moya.pdf |
Exemplaires (1)
| Code-barres | Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|---|
| 099167 | THESE15/0005 | Thèse | Rennes | Magasin | Empruntable Disponible |
Documents numériques (1)
 these_Moya URL |