Institut de Recherche pour le Développement, Montpellier 34394, France.
J Nutr. 2010 Mar;140(3):625-9. doi: 10.3945/jn.109.114223. Epub 2010 Jan 20.
Although infections contribute to growth faltering in preschool children, malaria prevention seems to have limited impact on height status. In 2002-2003, a malaria intermittent preventive treatment (IPT) trial was conducted in Senegal, including randomly selected preschool children from 11 villages. A rapid decrease in stunting prevalence (from 28.3 to 16.3%; P < 0.0001) was reported in both intervention and placebo groups. During this 15-mo period, both groups of children benefited from active detection and prompt treatment of malaria attacks. In this study, we investigated whether management of malaria morbidity could explain the improvement of height status. An anthropometric survey, conducted in September 2004 in the area, included 929 2- to 5-y-old children. Some 539 children, previously included in the 2002-2003 IPT trial, benefited from active malaria morbidity management and formed the malaria trial group. The remaining 390 children constituted the control group. Mean height-for-age and stunting prevalence in September 2004 were compared between groups adjusting for age and mother's activity. Mean height-for-age Z-scores did not differ between trial (-1.17 +/- 0.93) and control children (-1.24 +/- 1.00; P = 0.25). Only 36- to 47-mo-old malaria trial children had a lower prevalence of stunting than controls of similar age (19.4 vs. 28.7%; P = 0.044). Compared with the usually slow progression of height status related to better living conditions, it seems very likely that the rapid improvement observed among IPT study children resulted from the trial. These findings suggest that improved health services provided by the trial may also have benefited children not included living in study villages.
虽然感染会导致学龄前儿童生长发育迟缓，但疟疾预防似乎对身高状况的影响有限。2002-2003 年，在塞内加尔进行了一项疟疾间歇性预防治疗（IPT）试验，包括从 11 个村庄中随机选择的学龄前儿童。干预组和安慰剂组的发育迟缓患病率均迅速下降（从 28.3%降至 16.3%；P<0.0001）。在这 15 个月期间，两组儿童均受益于疟疾发作的积极检测和及时治疗。在这项研究中，我们调查了疟疾发病率的管理是否可以解释身高状况的改善。2004 年 9 月在该地区进行的一项人体测量调查包括 929 名 2 至 5 岁的儿童。之前参加过 2002-2003 年 IPT 试验的 539 名儿童受益于积极的疟疾发病率管理，形成了疟疾试验组。其余 390 名儿童构成对照组。调整年龄和母亲活动后，比较 2004 年 9 月两组的平均身高年龄和发育迟缓患病率。试验组和对照组儿童的平均身高年龄 Z 评分无差异（-1.17 +/- 0.93 和-1.24 +/- 1.00；P = 0.25）。只有 36-47 月龄的疟疾试验儿童的发育迟缓患病率低于同龄对照组（19.4%比 28.7%；P = 0.044）。与生活条件改善相关的身高状况的缓慢进展相比，IPT 研究儿童中观察到的快速改善似乎非常可能是试验的结果。这些发现表明，试验提供的改善健康服务也可能使未参加研究村庄的儿童受益。
