Maternal plasma 25-hydroxyvitamin D (25(OH)D) status and its association with pregnancy outcomes in malaria holoendemic regions of sub-Saharan Africa is poorly defined. We examined this association and any potential interaction with malaria and helminth infections in an ongoing pregnancy cohort study in Kenya. The association of maternal plasma 25(OH)D status with pregnancy outcomes and infant anthropometric measurements at birth was determined in a subset of women (n = 63). Binomial and linear regression analyses were used to examine associations between maternal plasma 25(OH)D and adverse pregnancy outcomes. Fifty-one percent of the women had insufficient (<75 nmol/L) and 21% had deficient (<50 nmol/L) plasma 25(OH)D concentration at enrollment. At birth, 74.4% of the infants had insufficient and 30% had deficient plasma 25(OH)D concentrations, measured in cord blood. Multivariate analysis controlling for maternal age and body mass index (BMI) at enrollment and gestational age at delivery found that deficient plasma 25(OH)D levels were associated with a four-fold higher risk of stunting in neonates (p = 0.04). These findings add to the existing literature about vitamin D and its association with linear growth in resource-limited settings, though randomized clinical trials are needed to establish causation.

Background. The Epstein-Barr virus (EBV) viral glycoprotein gp350 has been proposed as a candidate antigen for an EBV vaccine. However, the proposed formulations of these vaccines have not taken into account the presence of 2 unique EBV strains (EBV-1 and EBV-2) present in areas of high incidence of the EBV-associated cancer, Burkitt lymphoma. Methods. In this study, we analyze the kinetics of EBV-1 and EBV-2 infection in an asymptomatic infant cohort from Kisumu, Kenya. We also analyzed the kinetics of the antibody response against 5 EBV antigens, gp350 (IgG and IgA), VCA (IgG), EBNA-1 (IgG), EAd (IgG), and Zta (IgG). Results. We observed a high frequency of coinfection with both EBV types over time, with the only observable defect in the antibody response in infants coinfected being a significantly lower level of anti-gp350 IgA at peak response. Gp350 IgA levels were also significantly lower in coinfected infants 2.5 months postinfection and at the time of coinfection. Conclusions. These results suggest that anti-gp350 IgA antibodies may be important for sterilizing immunity against secondary infection. These findings have implications for the development of an efficacious EBV vaccine to prevent both EBV-1 and EBV-2 infection in a population at high risk for Burkitt lymphoma.

Abstract.Increasing the active participation of professional women in vector control (VC) activities may help promote greater gender equity in the workplace and reduce the burden of vector-borne diseases. This stakeholder survey examined the current roles and perspective of professionals employed in the VC sector in Kenya, Indonesia, India, and other countries. The largest barriers that women face in pursuing leadership roles in the VC sector include lack of awareness of career opportunities, limitations based on cultural norms, and the belief that VC is men’s work. These barriers could be addressed through improving education and recruitment campaigns, as well as supporting higher education and mentoring programs. Females were almost six times more likely to be encouraged to pursue leadership positions in their organization compared with male respondents (odds ratio = 5.9, P > 0.03, 95% confidence interval: 1.19, 29.42). These findings suggest that once women are recruited into the VC workforce, they face minimal discrimination and have increased leadership opportunities.

Appropriate gestational weight gain is necessary for optimal pregnancy outcomes. We examined if this relationship holds in our perinatal cohort in Kenya by determining the effect of maternal weight change on preterm birth and adverse pregnancy outcomes.One‐hundred and ninety‐one women were followed up through delivery and information on birth outcomes was recorded. Data on weight was available for four antenatal visits over the course of the pregnancy. Rate of weight change was defined as the difference between last observed weight and enrollment weight divided by the corresponding time difference. Weight loss was defined as negative rate of weight change and low birth weight (LBW) as birth weight less than 2,500 grams. Preterm delivery was defined as delivery at less than 37 weeks of pregnancy. Binomial regression was used to estimate risk ratios and p‐values for the association between weight loss and pregnancy outcomes.The median gestational age at enrollment was 22 weeks (IQR: 18‐26 weeks). The median rate of weight change over the course of pregnancy was 0.25 kg/week (IQR: 0.12‐0.44kg/week). 26% of women lost weight over the course of pregnancy. 6% of neonates had LBW and 21% of all births were preterm. On adjusting for maternal age and BMI at enrollment, women who lost weight had 2.22 greater risk of preterm birth than women who did not lose weight (95% CI =1.03, 4.77; p=0.04).Over 1 in 4 women in our study lost weight during the course of pregnancy. Future studies need to identify appropriate interventions for improving weight gain and optimizing birth outcomes.Funding: National Institutes of Health