长效驱虫蚊帐用于疟疾预防后的不良事件的发生率和预测因素：刚果民主共和国基于社区的横断面研究。

Prevalence and predictors of adverse events following exposure to long-lasting insecticidal nets used for malaria prevention: a community based cross-sectional study in the Democratic Republic of the Congo.

机构信息

Unit of Entomology, Department of Parasitology, National Institute of Biomedical Research, Kinshasa, Democratic Republic of the Congo.

Unit of Clinical Pharmacology and Pharmacovigilance, Department of Base Science, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of the Congo.

出版信息

Malar J. 2023 Feb 1;22(1):35. doi: 10.1186/s12936-023-04458-w.

DOI:10.1186/s12936-023-04458-w

PMID:36726181

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9893672/

Abstract

BACKGROUND

Malaria morbidity and mortality increase in the Democratic Republic of the Congo (DRC) may be the consequence of the low utilization rate of long-lasting insecticidal nets (LLINs) resulting from poor compliance due to adverse events (AEs). This study aimed at determining the prevalence and predictors of AEs following the mass distribution of LLINs in the Kisantu Health Zone (KHZ), a high malaria-endemic region in the DRC.

METHODS

A community-based cross-sectional study embedded was conducted within a randomized controlled trial (RCT) after the mass distribution of LLINs in 30 villages located in DRC KHZ. A three-stage sampling method was used without replacement to select 1790 children. Data was collected on adverse events (AEs) using a reporting form and information on demographics, nutritional status, and house characteristics. This was done using a structured questionnaire administered to household heads. Logistic regression models were used to identify predictors of AEs following the mass distribution of LLINs.

RESULT

In a total of 1790 children enrolled, 17.8% (95% CI 16.1-19.7) experienced AEs. The most common AEs were respiratory-related (61%). Around 60% of AEs occurred within 24 h of use, and 51% were resolved without treatment. Sleeping under deltamethrin LLINs (Adjusted OR, 95% CI 5.5 [3.8-8.0]) and zinc roofing (Adjusted OR, 95% CI 1.98 [1.1-3.57]) were associated with the risk of reporting an AE following the mass distribution of LLINs.

CONCLUSION

Approximately 1 out of 5 children had an AE within 24 h following LLIN use. These adverse events were often respiratory-related. LLINs and roofing types were associated with a higher risk of reporting AEs. However, further research using a robust study design is needed to confirm these findings. Future studies should design and implement interventions aiming to reduce AEs and improve compliance with LLINs.

摘要

背景

刚果民主共和国（DRC）的疟疾发病率和死亡率上升，可能是由于长效驱虫蚊帐（LLINs）的利用率低所致，这是由于不良反应（AEs）导致的合规性差所致。本研究旨在确定在基桑图卫生区（KHZ）大规模分发 LLINs 后，AEs 的流行率和预测因素，该地区是 DRC 的一个疟疾高发地区。

方法

在基桑图卫生区（KHZ）大规模分发 LLINs 后，进行了一项基于社区的横断面研究，该研究嵌入了一项随机对照试验（RCT）。采用无替换的三阶段抽样方法，选择了 30 个村庄的 1790 名儿童。使用报告表收集不良反应（AEs）数据，并收集人口统计学、营养状况和房屋特征信息。这是通过向户主发放结构化问卷完成的。使用逻辑回归模型确定大规模分发 LLINs 后 AEs 的预测因素。

结果

共纳入 1790 名儿童，17.8%（95%CI 16.1-19.7）发生 AEs。最常见的 AEs 是与呼吸有关的（61%）。大约 60%的 AEs 在使用后 24 小时内发生，51%未经治疗即可解决。使用氯菊酯 LLINs（调整后的 OR，95%CI 5.5 [3.8-8.0]）和锌屋顶（调整后的 OR，95%CI 1.98 [1.1-3.57]）与大规模分发 LLINs 后报告 AE 的风险相关。

结论

大约每 5 名儿童中就有 1 名在使用 LLINs 后 24 小时内发生 AEs。这些不良事件通常与呼吸有关。LLINs 和屋顶类型与报告 AEs 的风险增加相关。然而，需要使用稳健的研究设计进行进一步研究以证实这些发现。未来的研究应设计和实施旨在减少 AEs 并提高 LLINs 依从性的干预措施。