Zheng W, Jiang H, Xiong Z, Jiang Z, Chen H
Nanchang Center for Disease Control and Prevention, Nanchang, 330038, China.
Iran J Parasitol. 2013 Jan;8(1):1-17.
The children aged under 5 years from vast African areas badly suffer from falciparum malaria and many of them die of this disease. Therapeutic efficacy of anti-malaria drugs, especially pyrimethamine-sulfadoxine (PS) and chloroquine (CQ) to falciparum malaria is frequently evaluated and reported in recent 10 years. Unfortunately, to date, these widespread materials and researches have not been systematically collected and analyzed. In our study, two investigators were employed to widely and independently gather researches on efficacy of PS vs. CQ mono-therapy of falciparum malaria in children aged below 5 years in unpublished and published databases. Meta-analyses were conducted in categories of PS group and CQ group respectively. Pooled OR of PS vs. CQ was 0.11 (95%CI, 0.05-0.24). PS showed higher therapeutic efficacy to falciparum malaria in less-than-5-year children than CQ. Random model was chosen to analyze for the heterogeneity existence between different studies. Subgroup analyses were performed, but heterogeneity was still presented. Heterogeneity might be caused by different resistance of falciparum malaria to PS and CQ in different settings. Malaria type associated with parasite species, basic information of PS and CQ, and PS & CQ resistant malaria control measures were demonstrated and discussed respectively in detail in this article.
来自非洲广大地区的5岁以下儿童深受恶性疟原虫疟疾之苦，其中许多儿童死于这种疾病。近十年来，抗疟疾药物，尤其是乙胺嘧啶-磺胺多辛（PS）和氯喹（CQ）对恶性疟原虫疟疾的治疗效果经常得到评估和报道。不幸的是，迄今为止，这些广泛的资料和研究尚未得到系统的收集和分析。在我们的研究中，两名研究人员被雇用来在未发表和已发表的数据库中广泛且独立地收集关于5岁以下儿童恶性疟原虫疟疾PS与CQ单药治疗效果的研究。分别对PS组和CQ组进行了荟萃分析。PS与CQ的合并比值比为0.11（95%可信区间，0.05 - 0.24）。在5岁以下儿童中，PS对恶性疟原虫疟疾的治疗效果高于CQ。选择随机模型分析不同研究之间是否存在异质性。进行了亚组分析，但异质性仍然存在。异质性可能是由不同环境中恶性疟原虫对PS和CQ的不同耐药性引起的。本文分别详细展示并讨论了与疟原虫种类相关的疟疾类型、PS和CQ的基本信息以及PS和CQ耐药疟疾的控制措施。
