Endemic parasitic infections during pregnancy and their impact on clinical and immunological outcomes in Gabon

Abstract

Parasitic infections such as malaria and schistosomiasis remain common among pregnant women in many parts of sub-Saharan Africa. These infections represent a major public health concern, as they can negatively affect maternal health, pregnancy outcomes, and the development of the unborn child. However, their effects on newborns' immune systems and early-life health remain incompletely understood.

This thesis, conducted in Gabon in collaboration with LUCID/LUMC in the Netherlands, investigates the clinical and immunological consequences of parasitic infections during pregnancy. The findings show that infections with multiple parasites are frequent and are associated with adverse birth outcomes, particularly low birth weight. The work also demonstrates that commonly used diagnostic methods often miss low-intensity infections in pregnant women, while newer, sensitive urine-based tests substantially improve detection.

In addition, the results provide evidence that praziquantel treatment for schistosomiasis during pregnancy is safe and beneficial for maternal health. Beyond clinical outcomes, this thesis demonstrates that maternal parasitic infections can influence immune development in newborns, resulting in distinct immune profiles at birth depending on the type of infection. Overall, this research highlights the importance of integrating improved diagnostic tools, effective treatment, and immunological monitoring into routine antenatal care. Such approaches are essential for reducing the burden of parasitic infections and improving maternal and child health in endemic settings.