Noguchi Memorial Institute for Medical Research, University of Ghana, Box LG581, Legon, Ghana.
Malar J. 2009 Dec 11;8:292. doi: 10.1186/1475-2875-8-292.
Whiles awaiting for the arrival of an effective and affordable malaria vaccine, there is a need to make use of the available control tools to reduce malaria risk, especially in children under five years and pregnant women. Intermittent preventive treatment (IPT) has recently been accepted as an important component of the malaria control strategy. This study explored the potential of a strategy of intermittent preventive treatment for children (IPTC) and timely treatment of malaria-related febrile illness in the home in reducing the parasite prevalence and malaria morbidity in young children in a coastal village in Ghana.
The study combined home-based delivery of IPTC among six to 60 months old and home treatment of suspected febrile malaria illness within 24 hours. All children between six and 60 months of age received intermittent preventive treatment using amodiaquine and artesunate, delivered by community assistants every four months (three times in 12 months). Malaria parasite prevalence surveys were conducted before the first and after the third dose of IPTC.
Parasite prevalence was reduced from 25% to 3% (p < 0.00, Mann-Whitney) one year after the inception of the two interventions. At baseline, 13.8% of the children were febrile (axillary temperature greater than or equal to 37.5 degree Celsius) compared to 2.2% at evaluation (post IPTC3 combined with timely home management of fever) (p < 0.00, Mann-Whitney).
The evaluation result indicates that IPTC given three times in a year combined with timely treatment of febrile malaria illness, impacts significantly on the parasite prevalence. The marked reduction in the parasite prevalence with this strategy points to the potential for reducing malaria-related childhood morbidity and mortality, and this should be explored by control programme managers.
在等待有效且负担得起的疟疾疫苗问世的同时，需要利用现有的控制工具来降低疟疾风险，尤其是五岁以下儿童和孕妇。间歇性预防治疗（IPT）最近已被视为疟疾控制策略的重要组成部分。本研究探讨了在加纳沿海村庄中，采用间歇性预防治疗儿童（IPTC）策略和及时在家中治疗疟疾相关发热性疾病的策略，以降低 6 至 60 个月龄儿童中寄生虫流行率和疟疾发病率的潜力。
该研究结合了为 6 至 60 个月龄儿童提供的家庭内 IPTC 和 24 小时内家庭治疗疑似疟疾发热疾病。所有 6 至 60 个月龄的儿童均接受社区助理每四个月（12 个月内 3 次）提供的阿莫地喹和青蒿琥酯间歇性预防治疗。在首次和第三次 IPTC 剂量后进行寄生虫流行率调查。
在两项干预措施开始一年后，寄生虫流行率从 25%降至 3%（p<0.00，Mann-Whitney）。基线时，13.8%的儿童发热（腋温≥37.5°C），而在评估时（IPTC3 后合并及时家庭管理发热）为 2.2%（p<0.00，Mann-Whitney）。
评估结果表明，每年给予三次 IPTC 并及时治疗疟疾发热疾病，对寄生虫流行率有显著影响。该策略显著降低寄生虫流行率表明，有可能降低与疟疾相关的儿童发病率和死亡率，这应引起控制规划管理人员的关注。
