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" Helminth infection and treatment among pregnant women in the Democratic Republic of Congo: "
Gadoth, Adva
Rimoin, Anne W
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Latin Dissertation
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English
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| Record Number
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906318
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TL2tb9r97g
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| Main Entry
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Gadoth, Adva
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| Title & Author
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Helminth infection and treatment among pregnant women in the Democratic Republic of Congo:\ Gadoth, AdvaRimoin, Anne W
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| College
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UCLA
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| Date
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2019
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2019
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| Abstract
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Helminth infections have an extremely high burden of disease, infecting over a billion people globally. Yet helminthiases remain heavily neglected in research and intervention efforts, especially in women of childbearing age. The exclusion of pregnant and breastfeeding women from preventive chemotherapy campaigns has exacerbated the problem in places like the Democratic Republic of Congo (DRC), a resource-poor, helminth endemic country with a high national fertility rate. The overarching aim of this dissertation is to better describe the landscape of helminthiases in DRC’s pregnant population, elucidating effects of prenatal infection on both maternal and neonatal health. Chapter 1 provides a summary of disease pathogenesis, prevention and control strategies for schistosomiasis and soil-transmitted helminths. Chapter 2 describes the prevalence, risk factors, and symptoms associated with urogenital schistosomiasis in a cross-sectional survey of women attending antenatal clinics in southeastern DRC; poor symptom recognition and a three-fold increase in the odds of sexually transmitted co-infections were identified amongst mothers harboring <i>S. haematobium</i>. Chapter 3 utilizes causal inference methods to examine the longitudinal effects of prenatal schistosomiasis on downstream offspring health, finding no distinction in the risk of adverse birth outcomes between mothers with treated infection and uninfected controls. Chapter 4 explores predictors and birth effects of prenatal anthelminthic use at scale, finding that in a nationally representative survey of mother-child pairs in DRC, indiscriminate anthelminthic drug use is unevenly distributed across sociodemographic lines and associated with significantly reduced odds of neonatal death. The findings of this dissertation reiterate the vulnerability of mothers and their offspring to unmitigated helminthiases, as well as the neutral or beneficial effects imparted by prenatal deworming. Given the evidence amassed herein, expansion and institutionalization of preventive chemotherapy at the national level—including the systematic incorporation of pregnant women in mass drug administration campaigns throughout DRC— is warranted.
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Rimoin, Anne W
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UCLA
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