尼日尔儿童在疟疾传播高峰季节每年与每半年一次的大规模阿奇霉素分发和疟原虫血症。
Annual Versus Biannual Mass Azithromycin Distribution and Malaria Parasitemia During the Peak Transmission Season Among Children in Niger.
机构信息
From the Francis I. Proctor Foundation.
Department of Ophthalmology.
出版信息
Pediatr Infect Dis J. 2018 Jun;37(6):506-510. doi: 10.1097/INF.0000000000001813.
BACKGROUND
Azithromycin has modest efficacy against malaria, and previous cluster randomized trials have suggested that mass azithromycin distribution for trachoma control may play a role in malaria control. We evaluated the effect of annual versus biannual mass azithromycin distribution over a 3-year period on malaria prevalence during the peak transmission season in a region with seasonal malaria transmission in Niger.
METHODS
Twenty-four communities in Matameye, Niger, were randomized to annual mass azithromycin distribution (3 distributions to the entire community during the peak transmission season) or biannual-targeted azithromycin distribution (6 distributions to children <12 years of age, including 3 in the peak transmission season and 3 in the low transmission season). Malaria indices were evaluated at 36 months during the high transmission season.
RESULTS
Parasitemia prevalence was 42.6% (95% confidence interval: 31.7%-53.6%) in the biannual distribution arm compared with 50.6% (95% confidence interval: 40.3%-60.8%) in the annual distribution arm (P = 0.29). There was no difference in parasite density or hemoglobin concentration in the 2 treatment arms.
CONCLUSIONS
Additional rounds of mass azithromycin distribution during low transmission may not have a significant impact on malaria parasitemia measured during the peak transmission season.
背景
阿奇霉素治疗疟疾的疗效有限，之前的集群随机试验表明，大规模分发阿奇霉素治疗沙眼可能在控制疟疾方面发挥作用。我们评估了在尼日尔季节性疟疾传播地区的 3 年期间，每年或每两年一次大规模分发阿奇霉素对高峰传播季节疟疾患病率的影响。
方法
尼日尔马塔梅耶的 24 个社区被随机分为每年大规模阿奇霉素分发（在高峰传播季节向整个社区分发 3 次）或每两年靶向阿奇霉素分发（向 <12 岁儿童分发 6 次，包括高峰传播季节 3 次和低传播季节 3 次）。在高传播季节的 36 个月评估疟疾指数。
结果
在两年分发组中，寄生虫血症患病率为 42.6%（95%置信区间：31.7%-53.6%），而在每年分发组中为 50.6%（95%置信区间：40.3%-60.8%）（P=0.29）。在 2 个治疗组中，寄生虫密度或血红蛋白浓度没有差异。
结论
在低传播期间增加大规模阿奇霉素的分发次数可能不会对高峰传播季节测量的疟疾寄生虫血症产生重大影响。
Zotero 插件