Basilion Eva V, Kilima Peter M, Turner Virginia M, Mecaskey Jeffrey W
International Trachoma Initiative, 441 Lexington Avenue, 16th Floor, New York, NY 10017-3910, USA.
Trans R Soc Trop Med Hyg. 2002 Nov-Dec;96(6):691-4. doi: 10.1016/s0035-9203(02)90353-6.
Azithromycin (Zithromax, Pfizer Inc., New York, NY, USA) is effective in the control of blinding trachoma. Community-based azithromycin treatment is recommended by the World Health Organization as part of a multipronged strategy aimed at the global elimination of binding trachoma by the year 2020. Paediatric trachoma is treated with azithromycin according to weight at a target dosage of 20 mg/kg. However, conventional weight-based treatment may be problematic in the field due to the logistical difficulties associated with weight scales. We assessed the accuracy of using height as a proxy for weight to determine azithromycin treatment in 4 countries--Viet Nam, Tanzania, Ghana, and Mali--where mass treatment programmes are underway. Population-based data collected from 1988 to 2000 were analysed using least squares regression. Height treatment schedules were developed for each data set. The accuracy of each schedule was evaluated according to the percentage of children receiving treatment within a dosage range of 20-30 mg/kg, a conservative estimate of the safe and effective treatment range for paediatric trachoma. Using height to determine dose, 89-95% of children would receive a dosage of 20-30 mg/kg. In these populations, height-based treatment is a reliable alternative to conventional weight-based treatment. Methods for developing height schedules presented in this analysis could be applied to other regions and therapeutics.
阿奇霉素（希舒美，辉瑞公司，纽约，美国）对控制致盲性沙眼有效。世界卫生组织推荐以社区为基础的阿奇霉素治疗，作为到2020年在全球消除致盲性沙眼的多管齐下战略的一部分。儿童沙眼采用阿奇霉素治疗时根据体重给药，目标剂量为20毫克/千克。然而，由于与体重秤相关的后勤困难，传统的基于体重的治疗在实地可能存在问题。我们评估了在正在开展大规模治疗项目的越南、坦桑尼亚、加纳和马里4个国家使用身高作为体重替代指标来确定阿奇霉素治疗剂量的准确性。使用最小二乘法回归分析了1988年至2000年收集的基于人群的数据。为每个数据集制定了根据身高确定治疗剂量的方案。根据在20 - 30毫克/千克剂量范围内接受治疗的儿童百分比评估每个方案的准确性，这是对儿童沙眼安全有效治疗范围的保守估计。使用身高来确定剂量时，89% - 95%的儿童将接受20 - 30毫克/千克的剂量。在这些人群中，基于身高的治疗是传统基于体重治疗的可靠替代方法。本分析中提出的制定根据身高确定治疗剂量方案的方法可应用于其他地区和治疗方法。
