Safety of integrated preventive chemotherapy for neglected tropical diseases.
Safety of integrated preventive chemotherapy for neglected tropical diseases.
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DOI：
10.1371/journal.pntd.0010700
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发表时间：
2022-09
影响因子：
3.8
通讯作者：
中科院分区：
文献类型：
--
作者：
预防性化疗（PC）是控制和消除被忽视的热带病（NTD）的核心策略。越来越多的重点已经给予“整合”的NTD计划内的卫生系统和共同管理的NTD药物提供了显着的方案效益。世界卫生组织（WHO）的指南反映了安全药物联合给药的现有证据，并强调了预防幼儿在PC期间窒息的措施。为了了解NTD药物联合给药如何影响PC的安全性，我们回顾了有关幼儿窒息风险和NTD药物联合给药安全性的文献。为了了解目前的药物共同管理的做法，我们调查了15个NTD项目经理和执行伙伴。在高收入国家，药物窒息是幼儿死亡的罕见原因。在资源匮乏的环境中，数据有限，但适合年龄的药物配方更少。在PC期间，致命的窒息虽然不常见，但主要发生在幼儿中;强迫他们吞下药片似乎是主要的风险因素。WHO目前推荐6种药物和5种可能的药物组合用于PC。在5种PC-NTD流行的105个国家中，有72个国家（68.6%）同时流行2种或2种以上疾病，在PC期间联合用药可能会受益。所有15名调查受访者均报告在PC期间合并用药。报告的对拒绝服药儿童的反应包括：不强迫儿童服药（60.0%），鼓励儿童服药（46.7%），稍后再带儿童服药（26.7%），提供阿奇霉素口服混悬液（POS）粉末（13.3%），让父母或社区成员进行干预以使儿童平静（6.7%）。PC期间NTD药物的联合给药似乎越来越常见。共同管理的PC药物的安全性需要注意窒息的预防，使用批准的药物组合，并增加获得适合年龄的药物配方。
Preventive chemotherapy (PC) is a central strategy for control and elimination of neglected tropical diseases (NTDs). Increased emphasis has been given to “integration” of NTD programs within health systems and coadministration of NTD drugs offers significant programmatic benefits. Guidance from the World Health Organization (WHO) reflects current evidence for safe drug coadministration and highlights measures to prevent choking of young children during PC. To understand how coadministration of NTD drugs might affect PC safety, we reviewed literature on choking risk in young children and safety of coadministered NTD drugs. To understand current practices of drug coadministration, we surveyed 15 NTD program managers and implementing partners. In high-income countries, choking on medication is an infrequent cause of death in young children. In low-resource settings, data are limited, but age-appropriate drug formulations are less available. During PC, fatal choking, although infrequent, occurs primarily in young children; forcing them to swallow tablets appears to be the major risk factor. The WHO currently recommends 6 drugs and 5 possible drug combinations for use in PC. Of 105 nations endemic for the 5 PC-NTDs, 72 (68.6%) are co-endemic for 2 or more diseases and could benefit from drug coadministration during PC. All 15 survey respondents reported coadministering medications during PC. Reported responses to a child refusing to take medicine included: not forcing the child to do so (60.0%), encouraging the child (46.7%), bringing the child back later (26.7%), offering powder for oral suspension (POS) for azithromycin (13.3%), and having parents or community members intervene to calm the child (6.7%). Coadministration of NTD drugs during PC appears to be increasingly common. Safety of coadministered PC drugs requires attention to choking prevention, use of approved drug combinations, and increased access to age-appropriate drug formulations.
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影响因子：
3.8
作者：
Mohammed KA;Haji HJ;Gabrielli AF;Mubila L;Biswas G;Chitsulo L;Bradley MH;Engels D;Savioli L;Molyneux DH
通讯作者：
Molyneux DH
影响因子：
3.8
作者：
Bronzan, Rachel N.;Dorkenoo, Ameyo M.;Sognikin, Koffi S.
通讯作者：
Sognikin, Koffi S.
影响因子：
11.8
作者：
Marks, Michael;Toloka, Hilary;Steer, Andrew C.
通讯作者：
Steer, Andrew C.
影响因子：
2.2
作者：
Friedman AJ;Ali SM;Albonico M
通讯作者：
Albonico M
影响因子：
--
作者：
Eigege, A.;Pede, E.;Njepuome, A. N.
通讯作者：
Njepuome, A. N.