The first 1000 days

The first 1000 days
“The first 1000 days: from the mother’s womb to infanthood is an important but often forgotten period of the pathway to a healthy life”.

In Lancet Infectious Diseases Dr Joseph Freer and colleagues today describe the effect of schistosomiasis during the first 1000 days-the period from conception to a child’s second birthday. These days can have lifelong effects on health, because this is a crucial phase of growth and development. There is increasing recognition of the burden and potential effects of schistosomiasis in women of reproductive age and young children. Exposure to schistosomes during pregnancy can modulate infant immune development and schistosomiasis can occur from early infancy, such that the high disease burden found in adolescents is often due to accumulation of infections with long-lived schistosomes from early life. Women of reproductive age and young children are largely neglected in mass drug administration programmes, but early treatment could avert subsequent disease. We evaluate the evidence that early schistosomiasis has adverse effects on birth, growth, and development. We also discuss the case for expanding public health interventions for schistosomiasis in women of reproductive age and preschool-age children, and the need for further research to evaluate the potential of treating women pre-conception to maximise health across the life course.

The Lancet Infectious Diseases: DOI: 10.1016/S1473-3099(17)30490-5