Willcox Merlin L, Graz Bertrand, Falquet Jacques, Sidibé Oumar, Forster Mathieu, Diallo Drissa
Antenna Technologies, Geneva, Switzerland.
Trans R Soc Trop Med Hyg. 2007 Dec;101(12):1190-8. doi: 10.1016/j.trstmh.2007.05.017. Epub 2007 Oct 24.
A prospective, dose-escalating, quasi-experimental clinical trial was conducted with a traditional healer using a decoction of Argemone mexicana for the treatment of malaria in Mali. The remedy was prescribed in three regimens: once daily for 3 days (Group A; n=23); twice daily for 7 days (Group B; n=40); and four times daily for the first 4 days followed by twice daily for 3 days (Group C; n=17). Thus, 80 patients were included, of whom 80% were aged<5 years and 25% were aged<1 year. All presented to the traditional healer with symptoms of malaria and had a Plasmodium falciparum parasitaemia>2000/microl but no signs of severe malaria. The proportions of adequate clinical response (ACR) at Day 14 were 35%, 73% and 65% in Groups A, B and C, respectively (P=0.011). At Day 14, overall proportions of ACR were lower in children aged<1 year (45%) and higher in patients aged>5 years (81%) (P=0.027). Very few patients had complete parasite clearance, but at Day 14, 67% of patients with ACR had a parasitaemia<2000/microl. No patient needed referral for severe disease. Only minor side effects were observed. Further research should determine whether this local resource could represent a first-aid home treatment in remote areas.
在马里,开展了一项前瞻性、剂量递增的准实验性临床试验,由一名传统治疗师使用墨西哥刺蓟煎剂治疗疟疾。该药物按三种方案给药:每日一次,共3天(A组;n = 23);每日两次,共7天(B组;n = 40);前4天每日四次,随后3天每日两次(C组;n = 17)。因此,共纳入80名患者,其中80%年龄<5岁,25%年龄<1岁。所有患者均因疟疾症状就诊于该传统治疗师,且恶性疟原虫血症>2000/微升,但无重症疟疾体征。A、B、C组在第14天的充分临床反应(ACR)比例分别为35%、73%和65%(P = 0.011)。在第14天,年龄<1岁儿童的ACR总体比例较低(45%),年龄>5岁患者的比例较高(81%)(P = 0.027)。极少有患者实现寄生虫完全清除,但在第14天,ACR患者中有67%的疟原虫血症<2000/微升。没有患者因重症疾病需要转诊。仅观察到轻微副作用。进一步的研究应确定这种当地资源是否可作为偏远地区的急救家庭治疗方法。