Consequences of Gestational Malaria on Birth Weight: Finding the Best Timeframe for Intermittent Preventive Treatment Administration

To investigate the consequences of intermittent preventive treatment (IPTp) timing on birth weight, we pooled data from two studies conducted in Benin between 2005 and 2010: a prospective cohort of 1037 pregnant women and a randomised trial comparing sulfadoxine-pyrimethamine (SP) to mefloquine in 1601 women. A total of 1439 women (752 in the cohort and 687 in the SP arm of the randomised trial) who delivered live singletons were analysed. We showed that an early intake of the first SP dose (4 months of gestation) was associated with a lower risk of LBW compared to a late intake (6–7 months of gestation) (aOR = 0.5 p = 0.01). We also found a borderline increased risk of placental infection when the first SP dose was administered early in pregnancy (aOR = 1.7 p = 0.1). This study is the first to investigate the timing of SP administration during pregnancy. We clearly demonstrated that women who had an early intake of the first SP dose were less at risk of LBW compared to those who had a late intake. Pregnant women should be encouraged to attend antenatal visits early to get their first SP dose and a third dose of SP could be recommended to cover the whole duration of pregnancy and to avoid late infections of the placenta

Семантичні зміни в лексичному складі російської та української мов

Использование вычислительной техники и радиоэлектроники способствовало формированию специальной группы лексических единиц. Номинация новых явлений и понятий является актуальной проблемой нынешнего этапа развития языка. Изменение семантического наполнения – это один из способов решения данной проблемы. Расширение или сужение семантического объема слов способствует обогащению лексической системы, а именно терминологии.Використання обчислювальної техніки та радіоелектроніки спричинило формування спеціальної групи лексичних одиниць. Номінація нових явищ та понять є актуальною проблемою теперішнього етапу розвитку мови. Зміна семантичного об'єму – це один із засобів вирішення даної проблеми. Звуження або розширення семантичного наповнення сприяє збагаченню лексичної системи, а саме термінології.Using of radio-electronic devices forced the formation of a special group of lexical units. The nomination of new processes and notions is an actual problem of today's language development. Semantic changes of existing units is one of the decisions of the problem. Widening and narrowing of semantic meanings promotes the enrichment of lexical system, especially the system of terminology

Malaria associated symptoms in pregnant women followed-up in Benin

<p>Abstract</p> <p>Background</p> <p>It is generally agreed that in high transmission areas, pregnant women have acquired a partial immunity to malaria and when infected they present few or no symptoms. However, longitudinal cohort studies investigating the clinical presentation of malaria infection in pregnant women in stable endemic areas are lacking, and the few studies exploring this issue are unconclusive.</p> <p>Methods</p> <p>A prospective cohort of women followed monthly during pregnancy was conducted in three rural dispensaries in Benin from August 2008 to September 2010. The presence of symptoms suggestive of malaria infection in 982 women during antenatal visits (ANV), unscheduled visits and delivery were analysed. A multivariate logistic regression was used to determine the association between symptoms and a positive thick blood smear (TBS).</p> <p>Results</p> <p>During routine ANVs, headache was the only symptom associated with a higher risk of positive TBS (aOR = 1.9; p < 0.001). On the occasion of unscheduled visits, fever (aOR = 5.2; p < 0.001), headache (aOR = 2.1; p = 0.004) and shivering (aOR = 3.1; p < 0.001) were significantly associated with a malaria infection and almost 90% of infected women presented at least one of these symptoms. Two thirds of symptomatic malaria infections during unscheduled visits occurred in late pregnancy and long after the last intermittent preventive treatment dose (IPTp).</p> <p>Conclusion</p> <p>The majority of pregnant women were symptomless during routine visits when infected with malaria in an endemic stable area. The only suggestive sign of malaria (fever) was associated with malaria only on the occasion of unscheduled visits. The prevention of malaria in pregnancy could be improved by reassessing the design of IPTp, i.e. by determining an optimal number of doses and time of administration of anti-malarial drugs.</p

Influence of the timing of malaria infection during pregnancy on birth weight and on maternal anemia in Benin

Although consequences of malaria in pregnancy are well known, the period of pregnancy in which infection has the highest impact is still unclear. In Benin, we followed up a cohort of 1,037 women through pregnancy until delivery. The objective was to evaluate the relationship between the timing of infection and birth weight, and maternal anemia at delivery. At the beginning of pregnancy, peripheral infections were associated with a decrease in mean birth weight (-98.5 g; P = 0.03) and an increase in the risk of anemia at delivery (adjusted odds ratio [aOR] = 1.6; P = 0.03). Infections in late pregnancy were related to a higher risk of maternal anemia at delivery (aOR = 1.7; P = 0.001). To fully protect the women during the whole pregnancy, already implemented measures (insecticide-treated nets and intermittent preventive treatment) should be reinforced. In the future, a vaccine against pregnancy-associated malaria parasites could protect the women in early pregnancy, which seems to be a high-risk period

Factors significantly associated with low birth weight (Multivariate analysis performed on 1439 women and adjusted on newborn's gender, study, number of consultations, bed net and education).

*<p>OR, odds ratio;</p>†<p>Body mass index.</p

General characteristics of the women and outcomes of the 2 studies.

#<p>mean, (Standard deviation (SD); range).</p>*<p>Differences between the 2 studies in proportions and means were compared using the χ² and the Student t-test, respectively.</p>†<p>Body mass index.</p

Factors significantly associated with placental infection (Multivariate analysis performed on 1261 women and adjusted on newborn's gender, number of consultations, bed net, underweight, education, duration of pregnancy and transmission period).

*<p>OR, odds ratio.</p

Study area of the randomized trial in Ouidah and STOPPAM.

<p>Study area of the randomized trial in Ouidah and STOPPAM.</p

Factors significantly associated with mean birth weight (Multivariate analysis performed on 1439 women and adjusted on bed net, education).

*<p>Body mass index.</p