两年季节性疟疾化学预防推广降低了马里库蒂拉卫生区儿童的疟疾发病率。
Two-Year Scale-Up of Seasonal Malaria Chemoprevention Reduced Malaria Morbidity among Children in the Health District of Koutiala, Mali.
机构信息
Institut National de Santé Publique, Bamako BP: 1771, Mali.
Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali.
出版信息
Int J Environ Res Public Health. 2020 Sep 11;17(18):6639. doi: 10.3390/ijerph17186639.
BACKGROUND
Previous controlled studies demonstrated seasonal malaria chemoprevention (SMC) reduces malaria morbidity by >80% in children aged 3-59 months. Here, we assessed malaria morbidity after large-scale SMC implementation during a pilot campaign in the health district of Koutiala, Mali.
METHODS
Starting in August 2012, children received three rounds of SMC with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ). From July 2013 onward, children received four rounds of SMC. Prevalence of malaria infection, clinical malaria and anemia were assessed during two cross-sectional surveys conducted in August 2012 and June 2014. Investigations involved 20 randomly selected clusters in 2012 against 10 clusters in 2014.
RESULTS
Overall, 662 children were included in 2012, and 670 in 2014. Children in 2014 versus those surveyed in 2012 showed reduced proportions of malaria infection (12.4% in 2014 versus 28.7% in 2012 ( = 0.001)), clinical malaria (0.3% versus 4.2%, respectively ( < 0.001)), and anemia (50.1% versus 67.4%, respectively ( = 0.001)). A propensity score approach that accounts for environmental differences showed that SMC conveyed a significant protective effect against malaria infection (IR = 0.01, 95% CI (0.0001; 0.09), clinical malaria (OR = 0.25, 95% CI (0.06; 0.85)), and hemoglobin concentration (β = 1.3, 95% CI (0.69; 1.96)) in 2012 and 2014, respectively.
CONCLUSION
SMC significantly reduced frequency of malaria infection, clinical malaria and anemia two years after SMC scale-up in Koutiala.
背景
先前的对照研究表明，季节性疟疾化学预防（SMC）可使 3-59 月龄儿童的疟疾发病率降低 80%以上。在此，我们评估了马里库蒂拉卫生区大规模 SMC 实施后的疟疾发病率。
方法
自 2012 年 8 月起，儿童接受三轮磺胺多辛-乙胺嘧啶（SP）和阿莫地喹（AQ）的 SMC。从 2013 年 7 月开始，儿童接受四轮 SMC。2012 年 8 月和 2014 年 6 月进行了两次横断面调查，评估疟疾感染、临床疟疾和贫血的患病率。调查涉及 2012 年的 20 个随机选择的集群和 2014 年的 10 个集群。
结果
共有 662 名儿童于 2012 年入选，670 名儿童于 2014 年入选。与 2012 年相比，2014 年的儿童中，疟疾感染比例（2014 年为 12.4%，2012 年为 28.7%）、临床疟疾（0.3%比 4.2%）和贫血（50.1%比 67.4%）的比例均降低（均 < 0.001）。采用考虑环境差异的倾向评分法，发现 SMC 对疟疾感染（IR = 0.01，95%CI（0.0001；0.09）、临床疟疾（OR = 0.25，95%CI（0.06；0.85）和血红蛋白浓度（β = 1.3，95%CI（0.69；1.96））均有显著的保护作用。
结论
在库蒂拉，SMC 大规模推广两年后，显著降低了疟疾感染、临床疟疾和贫血的发生率。
Zotero 插件