Pappaioanou M, Lobel H O, Campbell C C
Bull World Health Organ. 1988;66(4):477-84.
In order to develop recommendations for malaria prophylaxis, a quantitative method is needed to balance the risk of Plasmodium falciparum malaria infections against the toxicity of antimalarial drugs. Using decision analysis, we estimated the expected mortality associated with three alternative regimens of prophylactic drugs for visitors to three areas with different risks of infection with chloroquine-resistant P. falciparum. The model used took into account the risks of malaria and of adverse reactions to antimalarial drugs. Estimates of the parameters used in the analysis were based on observations made on U.S. travellers. Reducing the risk of malaria infection was found to have a far greater impact on lowering the expected mortality than that of increasing the chemoprophylactic efficacy of the drugs used, thereby emphasizing the need for travellers to use anti-mosquito measures in malarious areas. The analytical method described can be used to define optimal malaria prevention strategies.
为制定疟疾预防建议，需要一种定量方法来权衡恶性疟原虫疟疾感染风险与抗疟药物毒性。我们运用决策分析，估算了前往三个对氯喹耐药恶性疟原虫感染风险不同地区的游客，使用三种不同预防药物方案相关的预期死亡率。所采用的模型考虑了疟疾风险和抗疟药物不良反应风险。分析中所用参数的估计基于对美国旅行者的观察。结果发现，降低疟疾感染风险对降低预期死亡率的影响远大于提高所用药物的化学预防效果，从而凸显旅行者在疟疾流行地区采取防蚊措施的必要性。所描述的分析方法可用于确定最佳疟疾预防策略。
