First malaria infections in a cohort of infants in Benin: biological, environmental and genetic determinants. Description of the study site, population methods and preliminary results.
First malaria infections in a cohort of infants in Benin: biological, environmental and genetic determinants. Description of the study site, population methods and preliminary results.
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DOI：
10.1136/bmjopen-2011-000342
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发表时间：
2012
期刊：
影响因子：
2.9
通讯作者：
Garcia A
中科院分区：
文献类型：
--
作者：
Le Port A;Cottrell G;Martin-Prevel Y;Migot-Nabias F;Cot M;Garcia A
发现妊娠期间胎盘感染疟疾与婴儿对疟疾的易感性有关。其他因素，如疟疾传播的强度和儿童的营养状况也可能起作用，但在以前的研究中没有充分考虑到这一点。这项研究的目的是准确评估环境、营养和生物决定因素在首次疟疾感染中所起的作用，对胎盘感染的作用特别感兴趣。本文的目的不是提出最终结果，而是概述研究的基本原理，描述所使用的方法并报告基线数据。一组婴儿从出生到18个月进行了寄生虫学（有症状和无症状寄生虫病）和营养随访。在研究期间收集了生态学、昆虫学和行为学数据。贝宁农村地区，疟疾传播有两个季节性高峰。656名妇女的婴儿愿意参加这项研究，在三家妇产诊所之一分娩，并居住在研究区域的九个村庄之一。婴儿首次出现疟疾寄生虫病的时间和频率，根据恶性疟原虫感染胎盘。11%的母亲在分娩时胎盘感染了疟疾。每6周捕获的蚊虫显示，年平均恶性疟原虫昆虫接种率为15.5，不同村庄间存在明显的时空差异。同样，降雨量的分布也不均匀，在两个雨季最大。考虑到所有可能影响新生儿疟疾状态的因素的多学科方法，本研究应该为胎盘疟疾在婴儿首次疟疾感染发生中的意义提供证据。本文介绍了在贝宁农村地区进行的一项关于影响婴儿首次疟疾感染的因素的研究。该研究的目的是在考虑到环境和行为因素的情况下，确认由感染疟疾的胎盘的母亲所生的婴儿首次感染疟疾的风险增加。本文详细介绍了在队列随访中使用的方法，并报告了基线数据。怀孕期间的疟疾可能会影响婴儿对首次疟疾感染的易感性。另一种解释是，一部分孕妇及其后代高度接触按蚊，这是一个混杂因素。通过研究感染胎盘与首次疟疾感染之间的关系，本研究将能够区分首次疟疾感染的环境和个体（即免疫耐受）风险因素。将提出具体建议，以充分保护孕妇。一个多学科（生物学，免疫学，营养，环境）的方法允许考虑协变量可能干扰胎盘感染。密切的寄生虫学随访（主动和被动）。在研究区进行了多次昆虫学调查。每6周（非连续）按按蚊捕获量估算昆虫学风险。人类着陆捕捉主要针对成年人，而新生儿是主要目标。未系统地在胎盘中搜索亚显微镜感染。
Malaria infection of the placenta during pregnancy was found to be associated with infant susceptibility to malaria. Other factors such as the intensity of malaria transmission and the nutritional status of the child might also play a role, which has not been adequately taken into account in previous studies. The aim of this study was to assess precisely the parts played by environmental, nutritional and biological determinants in first malaria infections, with a special interest in the role of placental infection. The objective of this paper is not to present final results but to outline the rationale of the study, to describe the methods used and to report baseline data. A cohort of infants followed with a parasitological (symptomatic and asymptomatic parasitaemia) and nutritional follow-up from birth to 18 months. Ecological, entomological and behavioural data were collected along the duration of the study. A rural area in Benin with two seasonal peaks in malaria transmission. 656 infants of women willing to participate in the study, giving birth in one of the three maternity clinics and living in one of the nine villages of the study area. The time and frequency of first malaria parasitaemias in infants, according to Plasmodium falciparum infection of the placenta. 11% of mothers had a malaria-infected placenta at delivery. Mosquito catches made every 6 weeks in the area showed an average annual P falciparum entomological inoculation rate of 15.5, with important time and space variations depending on villages. Similarly, the distribution of rainfalls, maximal during the two rainy seasons, was heterogeneous over the area. Considering the multidisciplinary approach of all factors potentially influencing the malaria status of newborn babies, this study should bring evidence on the implication of placental malaria in the occurrence of first malaria infections in infants. The article presents a study on the factors influencing first malaria infections in infants, performed in a rural area of Benin. The aim of the study was to confirm the existence of an increased risk to present first malaria infection in infants born from a mother with malaria-infected placenta, while taking into account environmental and behavioural factors. The article presents in detail the methods used in the follow-up of the cohort and reports baseline data. Malaria during pregnancy could have an impact on infants' susceptibility to first malaria infections. An alternative explanation is a high exposure to anopheles in a subset of pregnant women and their offspring, acting as a confounding factor. This study will be able to discriminate between environmental and individual (ie, immune tolerance) risk factors of first malaria infection by studying the association between infected placenta and first malaria infections. Specific recommendations will be given to protect pregnant women adequately. A multidisciplinary (biological, immunological, nutritional, environmental) approach allowing to take into consideration covariates potentially interfering with placental infection. Close parasitological follow-up (both active and passive). Repeated entomological surveys in the study area. Approximation of the entomological risk by anopheles captures every 6 weeks (not continuous). Human landing catches performed on adults, while newborn babies are the main target. Submiscroscopic infections not systematically searched for in placenta.
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影响因子：
3
作者：
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通讯作者：
McKenzie FE
影响因子：
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作者：
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DOI：
10.1073/pnas.0601559103
发表时间：
2006-05-02
影响因子：
11.1
作者：
Raso, G;Vounatsou, P;Utzinger, J
通讯作者：
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DOI：
10.1073/pnas.0510576103
发表时间：
2006-02-14
影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
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