Maternal peripartum serum DDT/E and urinary pyrethroid metabolite concentrations and child infections at 2 years in the VHEMBE birth cohort

dc.contributor.authorHuang, Jonathan
dc.contributor.authorEskenazi, Brenda
dc.contributor.authorBornman, Maria S. (Riana)
dc.contributor.authorRauch, Stephen
dc.contributor.authorChevrier, Jonathan
dc.date.accessioned2019-11-01T06:17:46Z
dc.date.available2019-11-01T06:17:46Z
dc.date.issued2018-06-14
dc.description.abstractBACKGROUND : Indoor residual spraying (IRS) of insecticides, conducted in low- and middle-income countries to control malaria, may result in high exposure to dichlorodiphenyltrichloroethane (DDT), its breakdown product dichlorodiphenyldichloroethylene (DDE), or pyrethroids. Animal studies suggest in utero exposure to these chemicals may increase childhood infection frequency. OBJECTIVES : We investigated associations between maternal DDT/E and pyrethroid metabolite concentration and child infection associations in an IRS setting in which susceptibility factors are common and infections are leading causes of child morbidity and mortality. METHODS : Using gas chromatography–mass spectrometry, we measured serum DDT/E and urinary pyrethroid metabolite concentrations in peripartum samples from 674 women participating in the Venda Health Examination of Mother, Babies and their Environment (VHEMBE) study. Counts of persistent child fevers, otitis media, and severe sore throat between 1 and 2 y of age were ascertained from maternal interviews. Associations between DDT/E and pyrethroid metabolite concentrations and infections were estimated using zero-inflated Poisson regression. We estimated relative excess risks due to interaction (RERI) with poverty, maternal energy intake, and maternal HIV status. RESULTS : Concentrations of DDT/E, particularly p,p′-DDE, were associated with higher rates of persistent fevers [IRR=1.21 (95% CI: 1.01, 1.46)], for a 10-fold increase in p,p′-DDE). This association was stronger among children from households below versus above the South African food poverty line [IRR=1.31 (95% CI: 1.08, 1.59) vs. IRR=0.93 (95% CI: 0.69, 1.25), respectively] and for children whose mothers had insufficient versus sufficient caloric intake during pregnancy [IRR=1.30 (95% CI: 1.07, 1.58) vs. IRR=0.96 (95% CI: 0.72, 1.28), respectively]. CONCLUSIONS : In utero IRS insecticide exposure may increase childhood infection rates. This was particularly apparent among children from poorer households or whose mothers had low energy intake during pregnancy.en_ZA
dc.description.departmentSchool of Health Systems and Public Health (SHSPH)en_ZA
dc.description.librarianam2019en_ZA
dc.description.sponsorshipThe National Institutes of Environmental Health Sciences (1R01ES020360-01)en_ZA
dc.description.urihttp://ehp.niehs.nih.goven_ZA
dc.identifier.citationHuang, J., Eskenazi, B., Bornman, R. et al. 2018, 'Maternal peripartum serum DDT/E and urinary pyrethroid metabolite concentrations and child infections at 2 years in the VHEMBE birth cohort', Environmental Health Perspectives, vol. 126, no. 6, pp. 067006-1-8.en_ZA
dc.identifier.issn0091-6765 (print)
dc.identifier.issn1552-9924 (online)
dc.identifier.other10.1289/EHP2657
dc.identifier.urihttp://hdl.handle.net/2263/72093
dc.language.isoenen_ZA
dc.publisherNational Institute of Environmental Health Sciencesen_ZA
dc.rights© The Author(s). 2019. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0.en_ZA
dc.subjectIndoor residual spraying (IRS)en_ZA
dc.subjectInsecticidesen_ZA
dc.subjectLow- and middle-income countries (LMICs)en_ZA
dc.subjectMalariaen_ZA
dc.subjectDichlorodiphenyldichloroethylene (DDE)en_ZA
dc.subjectHuman immunodeficiency virus (HIV)en_ZA
dc.subjectPyrethroidsen_ZA
dc.subjectChildhood infection frequencyen_ZA
dc.subjectRisks due to interaction (RERI)en_ZA
dc.titleMaternal peripartum serum DDT/E and urinary pyrethroid metabolite concentrations and child infections at 2 years in the VHEMBE birth cohorten_ZA
dc.typeArticleen_ZA

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