Opoku Ernest Cudjoe, Olsen Annette, Browne Edmund, Hodgson Abraham, Awoonor-Williams John K, Yelifari Lawrence, Williams John, Magnussen Pascal
Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana.
Copenhagen School of Global Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;
Glob Health Action. 2016 Sep 14;9:32197. doi: 10.3402/gha.v9.32197. eCollection 2016.
The benefits of integrated control of malaria, schistosomiasis, and soil-transmitted helminth infections have not been fully explored in Ghanaian schoolchildren.
To assess the impact of co-administered artemether-lumefantrine plus albendazole, and artemether-lumefantrine plus albendazole plus praziquantel compared to albendazole plus praziquantel on anaemia, sustained attention, and recall in schoolchildren.
This three-arm, open-label intervention study was carried out in Ghana among class three schoolchildren. Artemether-lumefantrine and albendazole were co-administered to 131 schoolchildren in Study Arm 1; artemether-lumefantrine, albendazole, and praziquantel to 90 children in Study Arm 2 versus albendazole and praziquantel to 127 children in Control Arm 3. Medicines were administered to all children at least 30 min after a meal. A HemoCue(®) photometer was used to measure haemoglobin (Hb), while the code transmission test (CTT), adapted from the Test of Everyday Attention for Children (TEA-Ch), was used to measure sustained attention and recall before-and-after interventions in June 2011 and June 2012.
We observed significant malaria parasite prevalence reductions of 62.8 and 59.2% in Study Arm 1 from 24.2 to 9.0%, p<0.01, and 59.2% in Study Arm 2 from 26.7 to 10.9%, p<0.01), respectively, compared to 8.93% in Control Arm 3 (from 34.7 to 31.6%, p>0.05). Meanwhile, anaemia prevalence reduced significantly (p<0.01) in all three study arms after interventions by 38.4% (from 19.8 to 12.2%), 20.7% (from 26.6 to 21.1%), and 36.0% (from 28.3 to 18.1%) in Study Arms 1, 2, and 3, respectively. Although the interventions had no significant effects on Hb levels, anaemia prevalence reduced insignificantly by 38.4 and 20.7% in Study Arms 1 and 2, respectively, compared to 36.0% in Control Arm 3. Among schoolchildren in Study Arms 1 and 2, mean CTT score improved significantly after interventions by 10.4% (from 3.18 to 3.55, p=0.01) and 20.5% (from 2.83 to 3.56, p=0.01) respectively, compared to 5.75% in Control Arm 3 (from 2.95 to 3.13, p=0.09). Likewise, mean recall test score improvements after interventions were 16.9% (from 2.07 to 2.49, p=0.01) and 27.9% (from 1.91 to 2.65, p=0.01) in Study Arms 1 and 2, respectively, compared to 18.3% (from 1.92 to 2.35, p=0.01) in Control Arm 3.
Combined intermittent preventive treatment of malaria and deworming reduced prevalence of anaemia and improved sustained attention and recall in schoolchildren. Best results for sustained attention and recall were seen in Study Arm 2.
在加纳学童中，尚未充分探讨疟疾、血吸虫病和土壤传播的蠕虫感染综合防治的益处。
评估蒿甲醚-本芴醇联合阿苯达唑，以及蒿甲醚-本芴醇联合阿苯达唑加吡喹酮与阿苯达唑加吡喹酮相比，对学童贫血、持续注意力和记忆力的影响。
这项三臂、开放标签干预研究在加纳的三年级学童中开展。研究组1的131名学童接受蒿甲醚-本芴醇和阿苯达唑联合用药；研究组2的90名儿童接受蒿甲醚-本芴醇、阿苯达唑和吡喹酮联合用药，而对照组3的127名儿童接受阿苯达唑和吡喹酮联合用药。所有儿童在饭后至少30分钟服药。使用HemoCue(®)光度计测量血红蛋白（Hb），同时采用改编自儿童日常注意力测试（TEA-Ch）的编码传递测试（CTT），在2011年6月和2012年6月干预前后测量持续注意力和记忆力。
与对照组3的8.93%（从34.7%降至31.6%，p>0.05）相比，我们观察到研究组1的疟原虫感染率显著降低62.8%，从24.2%降至9.0%，p<0.01，研究组2的疟原虫感染率显著降低59.2%，从26.7%降至10.9%，p<0.01。同时，干预后所有三个研究组的贫血患病率均显著降低（p<0.01），研究组1、2和3分别降低38.4%（从19.8%降至12.2%）、20.7%（从26.6%降至21.1%）和36.0%（从28.3%降至18.1%）。尽管干预对Hb水平无显著影响，但研究组1和2的贫血患病率分别无显著降低38.4%和20.7%，而对照组3降低36.0%。在研究组1和2的学童中，干预后平均CTT得分分别显著提高10.4%（从3.18提高到3.55，p=0.01）和20.5%（从2.83提高到3.56，p=0.01），而对照组3提高5.75%（从2.95提高到3.13，p=0.09）。同样，干预后研究组1和2平均记忆力测试得分分别提高16.9%（从2.07提高到2.49，p=0.01）和27.9%（从1.91提高到2.65，p=0.01），而对照组3提高18.3%（从从1.92提高到2.35，p=0.01）。
疟疾和驱虫联合间歇性预防性治疗降低了学童贫血患病率，改善了持续注意力和记忆力。研究组2在持续注意力和记忆力方面取得了最佳效果。
