Phillips-Howard Penelope A, Nahlen Bernard L, Kolczak Margarette S, Hightower Allen W, ter Kuile Feiko O, Alaii Jane A, Gimnig John E, Arudo John, Vulule John M, Odhacha Amos, Kachur S Patrick, Schoute Erik, Rosen Daniel H, Sexton John D, Oloo Aggrey J, Hawley William A
Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Am J Trop Med Hyg. 2003 Apr;68(4 Suppl):23-9.
A group-randomized controlled trial of insecticide (permethrin)-treated bed nets (ITNs) was conducted in an area of high perennial malaria transmission in western Kenya to test the effect of ITNs on all-cause mortality in children 1-59 months of age. Child deaths were monitored over a two-year period by biannual household census in Asembo (1997-1998) and in Gem (1998-1999). Overall, 1,722 deaths occurred in children 1-59 months followed for 35,932 child-years. Crude mortality rates/1,000 child-years were 51.9 versus 43.9 in control and ITN villages in children 1-59 months old. The protective efficacy (PE) (95% confidence interval) adjusted for age, study year, study site, and season was 16% (6-25%). Corresponding figures in 1-11- and 12-59-month-old children in control and ITN villages were 133.3 versus 102.3, PE = 23% (11-34%) and 31.1 versus 28.7, PE = 7% (-6-19%). The numbers of lives saved/1,000 child-years were 8, 31, and 2 for the groups 1-59, 1-11, and 12-59 months old, respectively. Stratified analysis by time to insecticide re-treatment showed that the PE of ITNs re-treated per study protocol (every six months) was 20% (10-29%), overall and 26% (12-37%) and 14% (-1-26%) in 1-11- and 12-59-month-old children, respectively. ITNs prevent approximately one in four infant deaths in areas of intense perennial malaria transmission, but their efficacy is compromised if re-treatment is delayed beyond six months.
在肯尼亚西部常年疟疾传播率较高的一个地区，开展了一项关于用杀虫剂（氯菊酯）处理过的蚊帐（ITN）的群组随机对照试验，以测试ITN对1至59个月大儿童全因死亡率的影响。在阿森博（1997 - 1998年）和杰姆（1998 - 1999年）通过每两年一次的家庭普查对儿童死亡情况进行了为期两年的监测。总体而言，在1至59个月大的儿童中，共随访了35932儿童年，发生了1722例死亡。1至59个月大儿童中，对照村和ITN村的粗死亡率/每1000儿童年分别为51.9和43.9。经年龄、研究年份、研究地点和季节调整后的保护效力（PE）（95%置信区间）为16%（6 - 25%）。对照村和ITN村1至11个月以及12至59个月大儿童的相应数据分别为133.3和102.3，PE = 23%（11 - 34%）以及31.1和28.7，PE = 7%（-6 - 19%）。1至59个月、1至11个月以及12至59个月年龄组每1000儿童年挽救的生命数分别为8、31和2。按杀虫剂重新处理时间进行分层分析表明，按照研究方案（每六个月）重新处理的ITN的PE总体为20%（10 - 29%），在1至11个月和12至59个月大儿童中分别为26%（12 - 37%）和14%（-1 - 26%）。在常年疟疾传播强烈的地区，ITN可预防约四分之一的婴儿死亡，但如果重新处理延迟超过六个月，其效力会受到影响。
