使用青蒿素联合疗法进行三年间歇性预防治疗对马里学龄儿童疟疾发病率的影响。
Impact of Three-Year Intermittent Preventive Treatment Using Artemisinin-Based Combination Therapies on Malaria Morbidity in Malian Schoolchildren.
作者信息
Maiga Hamma, Barger Breanna, Sagara Issaka, Guindo Abdoulaye, Traore Oumar B, Tekete Mamadou, Dara Antoine, Traore Zoumana I, Diarra Modibo, Coumare Samba, Kodio Aly, Toure Ousmane B, Doumbo Ogobara K, Djimde Abdoulaye A
机构信息
Institut National de Santé Publique, Bamako 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 1805, Mali.
出版信息
Trop Med Infect Dis. 2020 Sep 17;5(3):148. doi: 10.3390/tropicalmed5030148.
UNLABELLED
Previous studies have shown that a single season of intermittent preventive treatment in schoolchildren (IPTsc) targeting the transmission season has reduced the rates of clinical malaria, all-cause clinic visits, asymptomatic parasitemia, and anemia. Efficacy over the course of multiple years of IPTsc has been scantly investigated.
METHODS
An open, randomized-controlled trial among schoolchildren aged 6-13 years was conducted from September 2007 to January 2010 in Kolle, Mali. Students were included in three arms: sulphadoxine-pyrimethamine+artesunate (SP+AS), amodiaquine+artesunate (AQ+AS), and control (C). All students received two full doses, given 2 months apart, and were compared with respect to the incidence of clinical malaria, all-cause clinic visits, asymptomatic parasitemia, and anemia.
RESULTS
A total of 296 students were randomized. All-cause clinic visits were in the SP+AS versus control (29 (20.1%) vs. 68 (47.2%); 20 (21.7%) vs. 41 (44.6%); and 14 (21.2%) vs. 30 (44.6%); < 0.02) in 2007, 2008, and 2009, respectively. The prevalence of asymptomatic parasitemia was lower in the SP+AS compared to control (38 (7.5%) vs. 143 (28.7%); and 47 (12.7%) vs. 75 (21.2%); < 0.002) in 2007 and 2008, respectively. Hemoglobin concentration was significantly higher in children receiving SP+AS (11.96, 12.06, and 12.62 g/dL) than in control children (11.60, 11.64, and 12.15 g/dL; < 0.001) in 2007, 2008, and 2009, respectively. No impact on clinical malaria was observed.
CONCLUSION
IPTsc with SP+AS reduced the rates of all-cause clinic visits and anemia during a three-year implementation.
未标注
先前的研究表明，针对传播季节对学童进行单季间歇性预防治疗（IPTsc）可降低临床疟疾、全因门诊就诊、无症状寄生虫血症和贫血的发生率。IPTsc多年来的疗效鲜有研究。
方法
2007年9月至2010年1月在马里的科勒对6至13岁的学童进行了一项开放、随机对照试验。学生被分为三组：周效磺胺-乙胺嘧啶+青蒿琥酯（SP+AS）、阿莫地喹+青蒿琥酯（AQ+AS）和对照组（C）。所有学生均接受两剂全量药物，间隔2个月给药，并比较临床疟疾、全因门诊就诊、无症状寄生虫血症和贫血的发生率。
结果
共296名学生被随机分组。2007年、2008年和2009年，SP+AS组的全因门诊就诊率分别低于对照组（29例（20.1%）对68例（47.2%）；20例（21.7%）对(41)例（44.6%）；14例（21.2%）对30例（44.6%）；(P\lt0.02)）。2007年和2008年，SP+AS组无症状寄生虫血症的患病率低于对照组（分别为38例（7.5%）对143例（28.7%）；47例（12.7%）对75例（21.2%）；(P\lt0.002)）。2007年、2008年和2009年，接受SP+AS治疗的儿童血红蛋白浓度显著高于对照组儿童（分别为11.96、12.06和12.62g/dL对11.60、11.64和12.15g/dL；(P\lt0.001)）。未观察到对临床疟疾的影响。
结论
在三年的实施过程中，使用SP+AS进行IPTsc降低了全因门诊就诊率和贫血发生率。
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