Background Dichlorodiphenyltrichloroethane (DDT) has been the centre of debate for several decades with a global call for a ban on its use, while organophosphates (OP) and pyrethroids are used extensively in agriculture. Both DDT, OPs and pyrethroids are being used extensively in South Africa in malaria control and small-scale agriculture. There is limited information from Africa on the adverse associations between DDT, OPs, pyrethroids and reproductive and neurobehavioural health outcomes.

Aim The aim of this study is to identify the impact of DDT, OP and pyrethroid exposure on the reproductive health of pregnant women and the neurobehavioural health outcomes of their offspring.

Method This longitudinal study with a 3 year follow-up period is being conducted in the uMkanyakude (exposed population) and uMgungundlovu (unexposed population) districts of KwaZulu-Natal, South Africa. A total of 350 pregnant women attending antenatal clinics at the district hospital and respective primary health clinics will be recruited (February – December 2016) and followed for 3 years. Maternal interviews (demographic, exposure and health data), and biomonitoring of exposure to pesticide (urine and blood) will take place at recruitment and annually for the duration of the study. Infant clinical and neurobehavioural assessments together with direct home observations to assess child development will take place. Biomonitoring of exposure to DDT, OPs and pyrethroids will take place at birth and annually for the duration of the study.

Results and discussion Data is currently being collected and information from the baseline recruitment interviews will be presented for the available women. Demographic, occupational and environmental pesticide exposure together with reproductive histories will be presented for the recruited cohort. This study will contribute knowledge on the relationship between DDT, OPs, pyrethroids and reproductive and neurobehavioural health outcomes in an African population.