Curtale F
Vitamin A Child Survival Project, Kathmandu, Nepal.
Panminerva Med. 1995 Dec;37(4):214-9.
The study examines the effect of mebendazole distribution (2 x 100 mg x 3 days) either as mass chemotherapy targeted to children 1 to 10 years old, or selective treatment of heavily infected children, over a two year period in sixteen rural villages of Nepal. Eight villages were covered with six monthly mass chemotherapy, provided by Community Health Volunteers, other eight with yearly selective treatment of heavily infected children based on clinical signs. Prevalence and intensity of infection, indirectly measured as the number of eggs per gram of faeces, were measured for A. lumbricoides and hookworms utilising the Kato thick-smear technique. At the end of two year intervention, the effect of both activities was similar on worm prevalence with a slightly significant difference (p < 0.05) on worm load in favour of mass chemotherapy. Furthermore a greater effect of mebendazole was reported, regardless of the type of intervention, on hookworms present at baseline with a lower prevalence (23.4%) than A. lumbricoides (47.6%). The study suggests that clinical diagnosis of heavily infected children may be a feasible way to direct selective treatment. Baseline prevalence seems to influence effectiveness of control programs. Further studies are needed to substantiate these observations.
该研究考察了在尼泊尔16个乡村为期两年的时间里，甲苯达唑（2×100毫克，共3天）以针对1至10岁儿童的群体化疗或对重度感染儿童进行选择性治疗这两种方式给药后的效果。八个村庄每六个月进行一次群体化疗，由社区卫生志愿者提供；另外八个村庄则根据临床症状每年对重度感染儿童进行选择性治疗。利用加藤厚涂片技术，以每克粪便中的虫卵数间接衡量蛔虫和钩虫的感染率及感染强度。在为期两年的干预结束时，两种活动对蠕虫感染率的影响相似，而在蠕虫负荷方面，群体化疗有略微显著的差异（p<0.05）。此外，无论干预类型如何，甲苯达唑对基线时存在的钩虫的作用更大，其感染率（23.4%）低于蛔虫（47.6%）。该研究表明，对重度感染儿童进行临床诊断可能是指导选择性治疗的一种可行方法。基线感染率似乎会影响控制项目的效果。需要进一步研究来证实这些观察结果。
