
Akusa Patrice MawaUganda Virus Research Institute · Immunology
Akusa Patrice Mawa
PhD
About
48
Publications
6,132
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951
Citations
Citations since 2017
Introduction
Additional affiliations
June 2015 - January 2017
January 2013 - January 2017
Medical Research Council / Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine
Position
- PhD Student
Description
- I am involved in studies on the impact of maternal infection with Mycobacterium tuberculosis on the infant response to BCG immunization.
October 2010 - present
Education
January 2013 - January 2017
September 2008 - September 2009
July 1996 - June 1999
Publications
Publications (48)
Background
Immuno-epidemiologists are often faced with multivariate outcomes, measured repeatedly over time. Such data are characterised by complex inter- and intra-outcome relationships which must be accounted for during analysis. Scientific questions of interest might include determining the effect of a treatment on the evolution of all outcomes...
Background
Over 200 million individuals worldwide are infected with Schistosoma species, with over half of infections occurring in children. Many children experience first infections early in life and this impacts their growth and development; however praziquantel (PZQ), the drug used worldwide for the treatment of schistosomiasis, only has regulat...
Schistosomiasis is the second most important human parasitic disease in terms of socioeconomic impact, causing great morbidity and mortality, predominantly across the African continent. For intestinal schistosomiasis, severe morbidity manifests as periportal fibrosis (PPF) in which large tracts of macro-fibrosis of the liver, visible by ultrasound,...
Introduction: The immunogenicity of BCG vaccination in infants differs between populations. We hypothesized that prenatal exposure to mycobacterial antigens might explain the differences in immune responses to BCG seen in other studies of infants in Africa and the United Kingdom (UK) and we explored this in birth cohorts in Uganda and the UK.
Mater...
Background: BCG has low efficacy in tropical countries. We hypothesized that maternal latent Mycobacterium tuberculosis (M.tb) infection (LTBI) results in fetal tolerance to mycobacterial antigens and impaired responses to BCG immunization. Methods: We enrolled 132 LTBI-positive and 150 LTBI-negative mothers and their babies in Entebbe, Uganda. Inf...
Introduction:
Prenatal exposures such as infections and immunisation may influence infant responses. We had an opportunity to undertake an analysis of innate responses in infants within the context of a study investigating the effects of maternal mycobacterial exposures and infection on BCG vaccine-induced responses in Ugandan infants.
Material a...
One contribution of 15 to a discussion meeting issue 'Biological challenges to effective vaccines in the developing world'. Bacille Calmette– Guérin (BCG) immunization provides variable protection against tuberculosis. Prenatal antigen exposure may have lifelong effects on responses to related antigens and pathogens. We therefore hypothesized that...
One contribution of 15 to a discussion meeting issue 'Biological challenges to effective vaccines in the developing world'. Bacille Calmette– Guérin (BCG) immunization provides variable protection against tuberculosis. Prenatal antigen exposure may have lifelong effects on responses to related antigens and pathogens. We therefore hypothesized that...
BCG is used widely as the sole licensed vaccine against tuberculosis, but it has variable efficacy and the reasons for this are still unclear. No reliable biomarkers to predict future protection against, or acquisition of, TB infection following immunisation have been identified. Lessons from BCG could be valuable in the development of effective tu...
Offspring of Schistosoma mansoni-infected women in schistosomiasis-endemic areas may be sensitised in-utero. This may influence their immune responsiveness to schistosome infection and schistosomiasis-associated morbidity. Effects of praziquantel treatment of S. mansoni during pregnancy on risk of S. mansoni infection among offspring, and on their...
Helminth infections may modulate immune responses to unrelated pathogens and allergens; these effects may commence prenatally. We addressed the hypothesis that anthelminthic treatment in pregnancy and early childhood would improve responses to immunisation and modulate disease incidence in early childhood with both beneficial and detrimental effect...
The overall prevalence of helminth infection at each routine annual visit.
(DOCX)
Trial Protocol.
(PDF)
The effect of quarterly albendazole during childhood on cognitive and motor development scores at age 5 years.
(DOCX)
Methods for assessment of motor and cognitive functioning at age five years.
(DOCX)
Measures of motor and cognitive ability used for assessments at age five years.
(DOCX)
Baseline characteristics of mothers enrolled in the factorial trial of anthelminthic treatment during pregnancy.
(DOCX)
CONSORT Checklist.
(DOC)
Globally, BCG vaccination varies in efficacy and has some non-specific protective effects. Previous studies comparing BCG strains have been small-scale, with few or no immunological outcomes and have compared TB-specific responses only. We aimed to evaluate both specific and non-specific immune responses to different strains of BCG within a large i...
Levels of cytokine response to schistosome worm antigen (SWA) and schistosome egg antigen (SEA) in maternal blood at delivery, cord blood and infant blood at age one year, by praziquantel versus placebo treatment during pregnancy. A PDF file of a table showing levels of cytokine production following stimulation of either maternal cord or infant blo...
Levels of antibodies to schistosome worm antigen (SWA) and schistosome egg antigen (SEA) in maternal blood at delivery, cord blood and infant blood at age one year, by praziquantel versus placebo treatment during pregnancy. A PDF file of a table showing the median plasma concentrations in μg/mL of antibodies to SWA and SEA and P-values for the rank...
Offspring of women with schistosomiasis may exhibit immune responsiveness to schistosomes due to in utero sensitisation or trans-placental transfer of antibodies. Praziquantel treatment during pregnancy boosts maternal immune responses to schistosome antigens and reduces worm burden. Effects of praziquantel treatment during pregnancy on responses a...
In 1994 and 2002, respectively, the World Health Organisation proposed that treatment for hookworm and schistosomiasis could be provided during pregnancy. It was hoped that this might have benefits for maternal anaemia, fetal growth and perinatal mortality; a beneficial effect on the infant response to immunisation was also hypothesised. Three tria...
In 1994 and 2002, respectively, theWorld Health Organisation proposed that treatment for hookworm and schistosomiasis
could be provided during pregnancy. It was hoped that this might have benefits for maternal anaemia, fetal growth and
perinatal mortality; a beneficial effect on the infant response to immunisation was also hypothesised. Three trial...
Helminth infections affect the human immune response. We investigated whether prenatal exposure to and treatment of maternal helminth infections affects development of an infant's immune response to immunisations and unrelated infections.
In this randomised, double-blind, placebo-controlled trial, we enrolled 2507 women in the second or third trime...
Background Helminth infections aff ect the human immune response. We investigated whether prenatal exposure
to and treatment of maternal helminth infections aff ects development of an infant’s immune response to
immunisations and unrelated infections.
Methods In this randomised, double-blind, placebo-controlled trial, we enrolled 2507 women in the...
Some vaccines show poor efficacy in tropical countries. Within a birth cohort in Uganda, we investigated factors that might influence responses to BCG and tetanus immunisation. Whole blood assay responses to crude culture filtrate proteins of Mycobacterium tuberculosis (cCFP)) and tetanus toxoid (TT) were examined among 1506 and 1433 one-year-olds,...
Praziquantel treatment of schistosomiasis during pregnancy was only recommended in 2002; hence the effects of treatment during pregnancy are not fully known. We have therefore evaluated the effects on infection intensity and the immunological effects of praziquantel treatment against Schistosoma mansoni during pregnancy, compared with treatment aft...
Praziquantel treatment of schistosomiasis boosts antischistosome responses, with type 2 helper T cell bias that may contribute to immunologically mediated killing and to protection against reinfection. Praziquantel treatment during pregnancy was recommended in 2002, but the immunological effects of the treatment had not been investigated.
A cohort...
Parasitic helminths have co-evolved with the mammalian immune system. Current hypotheses suggest that immunological stimulation in the presence of helminths is balanced by immuno-regulation and by the broad spectrum of mechanisms possessed by helminths for countering the host immune response. The degree to which this balance is perfected, and the m...
Studies showing that helminths stimulate type 2 cytokine responses and influence responses to unrelated antigens suggest that helminths may accelerate human immunodeficiency virus type 1 (HIV-1) disease progression in coinfected individuals and that antihelminthic therapy may be beneficial. By the same logic, however, the increase in type 2 cytokin...
Maternal schistosomiasis and filariasis have been shown to influence infant responses to neonatal bacille Calmette-Guérin (BCG) immunisation but the effects of maternal hookworm, and of de-worming in pregnancy, are unknown.
In Entebbe, Uganda, we conducted a randomised, double-blind, placebo-controlled trial of a single dose of 400 mg of albendazol...
We show that Ugandan adults coinfected with Schistosoma mansoni and human immunodeficiency virus type 1 (HIV-1) are able to mount S. mansoni-specific immune responses but that few such responses increase after treatment with praziquantel (PZQ). Levels of soluble
wormantigen (SWA)-specific immunoglobulin (Ig) G1, IgG2, IgG3, IgG4, interleukin (IL)-...
To determine whether tuberculin skin testing (TST) is associated with an increase in human immunodeficiency virus (HIV) viral load, and to examine the effect of TST on anti-mycobacterial immune responses.
A nested cohort study of HIV-1-infected adults.
Forty-two participants (21 TST-positive and 21 TST-negative) from a larger cohort were recruited...
It has been proposed that helminth infection may exacerbate HIV progression by promoting activation of ‘type 2’ immune responses.
To examine this hypothesis, we investigated helminth infection in a cohort of HIV-1-seropositive adults in Entebbe, Uganda,
during November 1999 to January 2000. Individuals with helminths were treated. At enrolment, aft...
Questions
Questions (2)
I have generated results for 17 cytokines/chemokines from a study with 7 follow up time points. I would like to use Principal Component Analysis (PCA), but I am not sure how to proceed. Any ideas? Is there any other analysis technique I can use for such a complex dataset?
I have culture supernatants from whole blood assay. I am measuring concentrations of cytokines/chemokines in them using Luminex assay. However, I am facing challenges of the probe of the Luminex equipment getting blocked during the run. Centrifuging the cultures before harvesting the supernatants does not seem to help much. Any ideas how I can go about this?
Projects
Projects (2)