Leenstra Tjalling, Phillips-Howard Penelope A, Kariuki Simon K, Hawley William A, Alaii Jane A, Rosen Daniel H, Oloo Aggrey J, Nahlen Bernard L, Kager Piet A, ter Kuile Feiko O
Department of Infectious Diseases, Tropical Medicine & AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Am J Trop Med Hyg. 2003 Apr;68(4 Suppl):86-93.
The impact of insecticide (permethrin)-treated bed nets (ITNs) on the health of adolescent schoolgirls was investigated during a community-based, randomized, controlled trial of ITNs in western Kenya. Two school-based cross-sectional surveys were conducted to determine the prevalence of malaria and anemia in 644 schoolgirls 12-18 years old in a rural area with intense perennial malaria transmission. In 12- and 13-year-old schoolgirls, ITNs were associated with a reduced prevalence of all cause anemia (hemoglobin level <12 g/dL, 16.9% versus 31.4%, adjusted odds ratio [OR] = 0.38, 95% confidence interval [CI] = 0.21, 0.69%) and a 0.34 g/dL (95% CI = 0.02, 0.66) increase in mean hemoglobin concentrations. No beneficial effect on all-cause anemia (adjusted OR = 0.79, 95% CI = 0.43, 1.45) or hemoglobin concentrations (difference in mean = 0.14 g/dL, 95% CI = -0.24, 0.53) was evident in older girls. In all age groups, no effect was found on malaria parasite prevalence or density, clinical malaria, all-cause morbidity, standard measures of nutritional status and growth, or the use of antimalarials and other medications. ITNs approximately halved the prevalence of mild anemia in young, school-attending, non-pregnant, adolescent girls, but had no impact in older girls or on other malaria-associated morbidity or nutritional status.
在肯尼亚西部开展的一项基于社区的杀虫剂（氯菊酯）处理蚊帐（ITN）随机对照试验中，研究了ITN对青春期女学生健康的影响。开展了两项基于学校的横断面调查，以确定在疟疾常年高强度传播的农村地区644名12至18岁女学生中疟疾和贫血的患病率。在12岁和13岁的女学生中，ITN与所有原因导致的贫血患病率降低相关（血红蛋白水平<12 g/dL，分别为16.9%和31.4%，调整后的优势比[OR]=0.38，95%置信区间[CI]=0.21，0.69%），且平均血红蛋白浓度增加0.34 g/dL（95%CI=0.02，0.66）。在年龄较大的女孩中，未发现对所有原因导致的贫血（调整后的OR=0.79，95%CI=0.43，1.45）或血红蛋白浓度有有益影响（平均差异=0.14 g/dL，95%CI=-0.24，0.53）。在所有年龄组中，未发现对疟原虫患病率或密度、临床疟疾、所有原因导致的发病率、营养状况和生长的标准指标，或抗疟药和其他药物的使用有影响。ITN使年轻、上学、未怀孕的青春期女学生中轻度贫血的患病率降低了约一半，但对年龄较大的女孩或其他与疟疾相关的发病率或营养状况没有影响。
