Department of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
PLoS One. 2011;6(7):e21862. doi: 10.1371/journal.pone.0021862. Epub 2011 Jul 7.
Malaria is the second highest contributor to the disease burden in Africa and there is a need to identify low cost prevention strategies. The objectives of this study were to estimate the prevalence of malaria parasitaemia among infants and to measure the association between peer counselling for exclusive breastfeeding (EBF), vitamin A supplementation, anthropometric status (weight and length) and malaria parasitaemia.
A cluster randomized intervention trial was conducted between 2006 and 2008 where 12 of 24 clusters, each comprising one or two villages, in Eastern Uganda were allocated to receive peer counselling for EBF. Women in their third trimester of pregnancy (based on the last normal menstrual period) were recruited in all 24 clusters and followed up until their children's first birthday. Blood was drawn from 483 infants between 3 and 12 months of age, to test for malaria parasitaemia.
The prevalence of malaria parasitaemia was 11% in the intervention areas and 10% in the control areas. The intervention did not seem to decrease the prevalence of malaria (PR 1.7; 95% CI: 0.9, 3.3). After controlling for potential confounders, infants not supplemented with Vitamin A had a higher prevalence for malaria compared to those who had been supplemented (PR 6.1; 95% CI: 2.1, 17.6). Among children supplemented with vitamin A, every unit increase in length-for-age Z (LAZ) scores was associated with a reduced prevalence in malaria (PR 0.5; 95% CI:0.4, 0.6). There was no association between LAZ scores and malaria among children that had not been supplemented.
Peer counselling for exclusive breastfeeding did not decrease the prevalence of malaria parasitaemia. Children that had not received Vitamin A supplementation had a higher prevalence of malaria compared to children that had been supplemented.
Clinicaltrials.gov: NCT00397150.
疟疾是非洲疾病负担第二高的疾病，需要确定低成本的预防策略。本研究的目的是估计婴儿疟疾寄生虫血症的患病率，并测量同伴咨询对纯母乳喂养（EBF）、维生素 A 补充、人体测量状况（体重和长度）和疟疾寄生虫血症之间的关联。
2006 年至 2008 年期间进行了一项集群随机干预试验，其中乌干达东部的 24 个集群中的 12 个集群，每个集群由一个或两个村庄组成，被分配接受纯母乳喂养的同伴咨询。所有 24 个集群均招募了处于妊娠晚期（根据末次正常月经计算）的妇女，并对其进行随访，直至其子女满一岁。从 483 名 3 至 12 个月大的婴儿中抽取血液，检测疟疾寄生虫血症。
干预区疟疾寄生虫血症的患病率为 11%，对照区为 10%。该干预似乎并没有降低疟疾的流行率（PR 1.7；95%CI：0.9，3.3）。在控制了潜在的混杂因素后，未补充维生素 A 的婴儿与补充过的婴儿相比，患疟疾的比例更高（PR 6.1；95%CI：2.1，17.6）。在补充了维生素 A 的儿童中，每增加一个长度-年龄 Z（LAZ）评分单位与疟疾的患病率降低相关（PR 0.5；95%CI：0.4，0.6）。在未补充维生素 A 的儿童中，LAZ 评分与疟疾之间没有关联。
同伴咨询对纯母乳喂养并没有降低疟疾寄生虫血症的患病率。与补充过维生素 A 的儿童相比，未接受维生素 A 补充的儿童患疟疾的比例更高。
Clinicaltrials.gov：NCT00397150。
