Terlouw Dianne J, Aidoo Michael A, Udhayakumar Venkatachalam, Kolczak Margarette S, Oloo Aggrey J, Kager Piet A, Lal Altaf A, Nahlen Bernard L, Kuile Feiko O ter
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Infect Dis. 2002 Dec 1;186(11):1661-8. doi: 10.1086/345363. Epub 2002 Nov 5.
The role of the sickle cell hemoglobin type as a determinant of treatment outcome with sulfadoxine-pyrimethamine was retrospectively studied in young children with uncomplicated falciparum malaria who lived in an area with intense perennial malaria transmission. Between 1993 and 1997, 2795 treatments involving 813 children were monitored. Sickle cell trait (HbAS) was present in 17.7% of the children. Two-and-a-half percent of the children experienced early clinical treatment failure by day 2-3, and 17.3% of the children were parasitemic on day 7. Treatments in HbAS children were less likely than those in HbAA children to result in persistence of parasitemia by day 3 (relative risk [RR], 0.66; 95% confidence interval [CI], 0.47-0.93; P=.02) or in parasitologic treatment failure on day 7 (RR, 0.51; 95% CI, 0.36-0.71; P<.0001). These results suggest that the HbAS phenotype should be included among factors that determine sulfadoxine-pyrimethamine treatment outcome.
在常年疟疾传播猖獗地区居住的患单纯性恶性疟的幼儿中，对镰状细胞血红蛋白类型作为磺胺多辛-乙胺嘧啶治疗结果决定因素的作用进行了回顾性研究。1993年至1997年期间，对涉及813名儿童的2795次治疗进行了监测。17.7%的儿童存在镰状细胞性状（HbAS）。2.5%的儿童在第2至3天出现早期临床治疗失败，17.3%的儿童在第7天仍有寄生虫血症。与HbAA儿童相比，HbAS儿童的治疗在第3天时寄生虫血症持续存在的可能性较小（相对风险[RR]，0.66；95%置信区间[CI]，0.47 - 0.93；P = 0.02），在第7天时寄生虫学治疗失败的可能性也较小（RR，0.51；95% CI，0.36 - 0.71；P < 0.0001）。这些结果表明，HbAS表型应纳入决定磺胺多辛-乙胺嘧啶治疗结果的因素之中。
