Marbiah N T, Petersen E, David K, Magbity E, Lines J, Bradley D J
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, United Kingdom.
Am J Trop Med Hyg. 1998 Jan;58(1):1-6. doi: 10.4269/ajtmh.1998.58.1.
A randomized controlled trial investigated the impact of community-wide use of mosquito nets impregnated with lambda-cyhalothrin alone or with dapsone/pyrimethamine (d/p) prophylaxis on clinical malaria due to perennially transmitted Plasmodium falciparum in children in the Bo district of Sierra Leone. The 17 study communities were pair-matched and randomly allocated to receive treated mosquito nets or no nets and the children (age range = 3 months-6 years) in each community were randomly allocated to receive d/p or placebo individually every two weeks. This resulted in each of the approximately 2,000 children recruited being in one of four study groups (impregnated mosquito nets and d/p prophylaxis, impregnated mosquito nets, d/p prophylaxis, and controls). The intervention phase of the study lasted 12 months. A total of 1,800 children attended more than 25% of the 48 total weekly morbidity surveillance surveys and were included in the analysis. The effects of the exclusive use of either treated mosquito nets or d/p prophylaxis on protection against clinical malaria due to P. falciparum was significantly similar (49% and 42%, respectively), while in combination this protective efficacy was significantly increased to 72% (95% confidence interval = 67-76%). Children in the control group had an average of 1.3 clinical malaria episodes per child annually compared with 0.65 episodes or 0.78 episodes for those using treated mosquito nets and d/p, respectively. Children using both treated mosquito nets and d/p prophylaxis had an average of 0.37 episodes per child. The interventions significantly reduced spleen rates and increased hematocrit values, and reduced the duration of episodes of clinical malaria.
一项随机对照试验调查了在塞拉利昂博城地区，社区广泛使用仅浸渍有氯氟氰菊酯的蚊帐或同时使用氨苯砜/乙胺嘧啶（d/p）预防措施，对儿童因常年传播的恶性疟原虫导致的临床疟疾的影响。17个研究社区进行配对匹配，随机分配接受经处理的蚊帐或不接受蚊帐，每个社区的儿童（年龄范围为3个月至6岁）每两周随机分配单独接受d/p或安慰剂。这使得招募的约2000名儿童中的每一个都被分到四个研究组之一（浸渍蚊帐和d/p预防、浸渍蚊帐、d/p预防以及对照组）。该研究的干预阶段持续12个月。共有1800名儿童参加了48次每周发病率监测调查中的超过25%，并被纳入分析。单独使用经处理的蚊帐或d/p预防措施对预防恶性疟原虫引起的临床疟疾的效果显著相似（分别为49%和42%），而联合使用时这种保护效力显著提高到72%（95%置信区间 = 67 - 76%）。对照组儿童平均每年每人有1.3次临床疟疾发作，而使用经处理蚊帐和d/p的儿童分别为0.65次发作或0.78次发作。同时使用经处理蚊帐和d/p预防措施的儿童平均每人有0.37次发作。这些干预措施显著降低了脾肿大率，提高了血细胞比容值，并缩短了临床疟疾发作的持续时间。
