马里儿童在接受间歇性预防疟疾治疗后的一年内的疟疾发病率：一项随机对照试验。
Malaria morbidity in children in the year after they had received intermittent preventive treatment of malaria in Mali: a randomized control trial.
机构信息
Malaria Research and Training Centre, Faculty of Medicine Pharmacy and Dentistry, University of Bamako, Bamako, Mali.
出版信息
PLoS One. 2011;6(8):e23390. doi: 10.1371/journal.pone.0023390. Epub 2011 Aug 12.
BACKGROUND
Intermittent preventive treatment of malaria in children (IPTc) is a promising strategy for malaria control. A study conducted in Mali in 2008 showed that administration of three courses of IPTc with sulphadoxine-pyrimethamine (SP) and amodiaquine (AQ) at monthly intervals reduced clinical malaria, severe malaria and malaria infection by >80% in children under 5 years of age. Here we report the results of a follow-on study undertaken to establish whether children who had received IPTc would be at increased risk of malaria during the subsequent malaria transmission season.
METHODS
Morbidity from malaria and the prevalence of malaria parasitaemia and anaemia were measured in children who had previously received IPTc with SP and AQ using similar surveillance methods to those employed during the previous intervention period.
RESULTS
1396 of 1508 children (93%) who had previously received IPTc and 1406 of 1508 children (93%) who had previously received placebos were followed up during the high malaria transmission season of the year following the intervention. Incidence rates of clinical malaria during the post-intervention transmission season (July-November 2009) were 1.87 (95% CI 1.76-1.99) and 1.73 (95% CI; 1.62-1.85) episodes per child year in the previous intervention and placebo groups respectively; incidence rate ratio (IRR) 1.09 (95% CI 0.99-1.21) (P = 0.08). The prevalence of malaria infection was similar in the two groups, 7.4% versus 7.5%, prevalence ratio (PR) of 0.99 (95% CI 0.73-1.33) (P = 0.95). At the end of post-intervention malaria transmission season, the prevalence of anaemia, defined as a haemoglobin concentration<11g/dL, was similar in the two groups (56.2% versus 55.6%; PR = 1.01 [95% CI 0.91-1.12]) (P = 0.84).
CONCLUSION
IPTc with SP+AQ was not associated with an increase in incidence of malaria episodes, prevalence of malaria infection or anaemia in the subsequent malaria transmission season.
TRIAL REGISTRATION
ClinicalTrials.gov NCT00738946.
背景
儿童间歇性预防治疗疟疾（IPTc）是一种有前途的疟疾控制策略。2008 年在马里进行的一项研究表明，每月间隔给予三剂磺胺多辛-乙胺嘧啶（SP）和阿莫地喹（AQ）的 IPTc 可使 5 岁以下儿童的临床疟疾、重症疟疾和疟疾感染减少 80%以上。在此，我们报告了一项后续研究的结果，该研究旨在确定接受 IPTc 的儿童在随后的疟疾传播季节是否会增加疟疾发病风险。
方法
使用与前一干预期间相同的监测方法，测量先前接受过 SP 和 AQ 的 IPTc 治疗的儿童的疟疾发病率以及疟疾寄生虫血症和贫血的患病率。
结果
在干预后的高疟疾传播季节，1508 名先前接受 IPTc 治疗的儿童中的 1396 名（93%）和 1508 名先前接受安慰剂治疗的儿童中的 1406 名（93%）接受了随访。在干预后的传播季节（2009 年 7 月至 11 月），前干预组和安慰剂组的临床疟疾发病率分别为 1.87（95%CI1.76-1.99）和 1.73（95%CI1.62-1.85）每儿童年；发病率比（IRR）为 1.09（95%CI0.99-1.21）（P=0.08）。两组的疟疾感染率相似，分别为 7.4%和 7.5%，患病率比（PR）为 0.99（95%CI0.73-1.33）（P=0.95）。在干预后疟疾传播季节结束时，两组的贫血患病率（定义为血红蛋白浓度<11g/dL）相似（56.2%与 55.6%；PR=1.01[95%CI0.91-1.12]）（P=0.84）。
结论
SP+AQ 的 IPTc 不会增加随后疟疾传播季节的疟疾发作次数、疟疾感染率或贫血发生率。
试验注册
ClinicalTrials.govNCT00738946。
Zotero 插件