# APBA Kısa Özet

The Entebbe Mother and Baby Study (EMaBS) is a longitudinal mother-infant cohort established in 2001 in Uganda to investigate whether treating helminth infections during pregnancy and early childhood improves vaccine responses and influences immune development. Over 2,500 mother-child pairs were recruited, and the cohort now follows children aged 19-22 years into adolescence and early adulthood, with ongoing data collection on long-term non-communicable disease risk.

# Çalışma neyi araştırdı?

EMaBS was designed to test the hypothesis that treating helminth infections during pregnancy and early childhood could improve children's responses to Bacillus Calmette-Guérin (BCG) and other vaccines given in infancy and influence immune responses to other infectious pathogens. The study also expanded its follow-up scope to address broader research questions, including the developmental programming of non-communicable diseases such as hypertension and dyslipidemia. Key exposures of interest included maternal helminth infection, antenatal albendazole treatment, and early-life malaria.

# Yöntem

The Entebbe Mother and Baby Study (EMaBS) was established in 2001 in Uganda. Two thousand five hundred and seven pregnant women were recruited when attending antenatal services at Entebbe General Hospital; 2,345 resulting live-born children were enrolled into the birth cohort. The original design was a double-blind, randomized, placebo-controlled trial of albendazole administered during pregnancy and early childhood. Follow-up was subsequently extended observationally to address further research questions and continue to the present day. Data collection includes anthropometry, blood pressure, lipid profiles, and immunological measurements. The cohort now follows children aged 19-22 years into adolescence and early adulthood.

# Temel bulgular

Initial results from EMaBS demonstrated that treating helminths in pregnancy and early childhood was safe and that treatment with albendazole reduced anaemia in mothers with heavy hookworm infections. Maternal anthelmintic treatment had small effects on infant response to tetanus immunisation, but no effect, either beneficial or detrimental, on the occurrence of infectious diseases in childhood. However, treatment of helminths during pregnancy resulted in increased rates of eczema in early childhood, although this was not sustained to nine years. Subsequent work in early adolescence found that postnatal weight gain was important in the developmental programming of blood pressure in this population and that current and early-life malaria modified blood pressure and lipid levels.

# Bulgular ne anlama geliyor?

The EMaBS findings suggest that helminth treatment during pregnancy is safe and can reduce maternal anaemia associated with heavy hookworm infection. However, the anticipated benefits on infant vaccine responses were modest, and treatment was not associated with reduced childhood infectious disease incidence. The emergence of increased eczema in early childhood following prenatal treatment, though transient, raises questions about immune modulation. Importantly, the cohort has provided insight into developmental origins of health and disease, demonstrating that early-life infections and growth patterns play a role in programming cardiovascular risk factors such as blood pressure and lipid levels in adolescence.

# Klinik önem

EMaBS provides a unique longitudinal dataset linking perinatal helminth exposure, anthelmintic treatment, and long-term health outcomes in a low-resource setting. The data inform discussions on the safety and efficacy of mass drug administration for helminth control, particularly regarding unintended effects on allergic disease risk. The cohort's ongoing follow-up into early adulthood contributes valuable evidence on the developmental programming of non-communicable diseases, though findings from a single Ugandan setting require cautious generalization.

# Sınırlılıklar

This profile is limited by the following factors: the observational follow-up after initial RCT phases limits causal inference for long-term outcomes; loss to follow-up may introduce selection bias; results from a single Ugandan setting may not generalize to other populations; pharmacological treatment protocols may differ from current World Health Organization guidelines; and citation metrics are bibliometric attention signals and do not by themselves establish clinical validity or evidence quality.