Schreiber Nadine, Kobbe Robin, Adjei Samuel, Adjei Ohene, Klinkert Mo-Quen, May Jürgen
Infectious Disease Epidemiology Group, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany.
Trop Med Int Health. 2007 Oct;12(10):1157-63. doi: 10.1111/j.1365-3156.2007.01902.x.
To assess how intermittent preventive treatment in infants (IPTi) with sulphadoxine-pyrimethamine (SP) affects Immunoglobulin (IgG) immune responses against Plasmodium falciparum in infants from rural Ghana.
Randomized, placebo-controlled and double-blinded clinical trial with participants randomized in blocks of 10 to receive either 250 mg sulphadoxine/2.5 mg pyrimethamine or placebo at the age of 3 (IPTi-1), 9 (IPTi-2) and 15 (IPTi-3) months and followed-up for 21 months. (i) Anti-P. falciparum IgG levels were measured in 180 children at the age of 9 months. (ii) Longitudinal study of the relationship between IgG levels and P. falciparum infections and/or clinical malaria in 17 naive children until they reached the age of 2 years.
IgG antibody levels against crude P. falciparum lysate were dependent on the frequency of preceding infections and significantly lower in children treated with SP.
Placebo-treated children had an indifferentially higher incidence of P. falciparum infections than clinically observed, which implicates an underestimation of the protective efficacy of IPTi. IgG profiles in 17 children followed up until the age of 2 years provided no evidence for impaired immune responses after a single dose of SP within the framework of IPTi.
评估在加纳农村地区，对婴儿采用周效磺胺-乙胺嘧啶（SP）进行间歇性预防治疗（IPTi）如何影响婴儿针对恶性疟原虫的免疫球蛋白（IgG）免疫反应。
随机、安慰剂对照、双盲临床试验，参与者按10人一组进行随机分组，在3个月（IPTi-1）、9个月（IPTi-2）和15个月（IPTi-3）时接受250毫克周效磺胺/2.5毫克乙胺嘧啶或安慰剂治疗，并随访21个月。（i）在180名9个月大的儿童中测量抗恶性疟原虫IgG水平。（ii）对17名未感染过疟疾的儿童进行纵向研究，观察其IgG水平与恶性疟原虫感染和/或临床疟疾之间的关系，直至他们满2岁。
针对恶性疟原虫粗裂解物的IgG抗体水平取决于先前感染的频率，接受SP治疗的儿童抗体水平显著较低。
接受安慰剂治疗的儿童恶性疟原虫感染发生率高于临床观察到的水平，这意味着对IPTi的保护效果估计不足。对17名随访至2岁的儿童进行的IgG分析结果显示，在IPTi框架内单次使用SP后，没有证据表明免疫反应受损。
