Shifts in the clinical epidemiology of severe malaria after scaling up control strategies in Mali.
Shifts in the clinical epidemiology of severe malaria after scaling up control strategies in Mali.
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DOI：
10.3389/fneur.2022.988960
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发表时间：
2022
影响因子：
3.4
通讯作者：
Thera MA
中科院分区：
文献类型：
--
作者：
Coulibaly D;Kone AK;Kane B;Guindo B;Tangara B;Sissoko M;Maiga F;Traore K;Diawara A;Traore A;Thera A;Sissoko MS;Doumbo OK;Travassos MA;Thera MA
在非洲许多地区，通过实施控制战略，如使用以青蒿素为基础的联合疗法、驱虫蚊帐、怀孕期间间歇性预防治疗和季节性疟疾化学预防，疟疾发病率有所下降。我们假设疟疾发病率的变化伴随着严重疟疾主要临床表型的变化。为了验证我们的假设，我们使用了2014-2019年持续的严重疟疾病例对照研究的数据来描述在马里班迪亚加拉、巴马科和西卡索登记的参与者所经历的严重形式的临床表型。我们还分析了巴马科一家国家转诊医院住院儿童的住院记录数据。在病例对照研究的97例重症疟疾病例中，以重症疟疾性贫血为主（49.1%）。脑疟发病频率为35.4例，16.5%的病例临床表现为混合型（脑疟合并重度贫血）。2013 - 2015年全国转诊医院记录数据显示，24.3%的病例为重度疟疾性贫血，而51.7%的病例为脑型疟疾。在SMC扩大后的几年中，严重疟疾贫血病例增加到30.1% (P = 0.019)，而脑型疟疾病例减少到45.5% （P = 0.025）。此外，每种严重疟疾表型的主要年龄组为0 - 1岁儿童。随着控制战略的实施而出现的疟疾发病率下降可能与严重疟疾临床表现模式的变化有关，包括严重疟疾负担可能向未接受季节性疟疾化学预防的年龄组转移。
A decrease in malaria incidence following implementation of control strategies such as use of artemisinin-based combination therapies, insecticide-impregnated nets, intermittent preventive treatment during pregnancy and seasonal malaria chemoprevention (SMC) has been observed in many parts of Africa. We hypothesized that changes in malaria incidence is accompanied by a change in the predominant clinical phenotypes of severe malaria. To test our hypothesis, we used data from a severe malaria case-control study that lasted from 2014–2019 to describe clinical phenotypes of severe forms experienced by participants enrolled in Bandiagara, Bamako, and Sikasso, in Mali. We also analyzed data from hospital records of inpatient children at a national referral hospital in Bamako. Among 97 cases of severe malaria in the case-control study, there was a predominance of severe malarial anemia (49.1%). The frequency of cerebral malaria was 35.4, and 16.5% of cases had a mixed clinical phenotype (concurrent cerebral malaria and severe anemia). National referral hospital record data in 2013–15 showed 24.3% of cases had severe malarial anemia compared to 51.7% with cerebral malaria. In the years after SMC scale-up, severe malarial anemia cases increased to 30.1%, (P = 0.019), whereas cerebral malaria cases decreased to 45.5% (P = 0.025). In addition, the predominant age group for each severe malaria phenotype was the 0–1-year-olds. The decrease in malaria incidence noted with the implementation of control strategies may be associated with a change in the clinical expression patterns of severe malaria, including a potential shift in severe malaria burden to age groups not receiving seasonal malaria chemoprevention.
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DOI：
10.1056/nejmoa1400116
发表时间：
2015-03-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
Seydel KB;Kampondeni SD;Valim C;Potchen MJ;Milner DA;Muwalo FW;Birbeck GL;Bradley WG;Fox LL;Glover SJ;Hammond CA;Heyderman RS;Chilingulo CA;Molyneux ME;Taylor TE
通讯作者：
Taylor TE
DOI：
10.1016/s0140-6736(20)32227-3
发表时间：
2020-12-05
期刊：
Lancet (London, England)
影响因子：
--
作者：
ACCESS-SMC Partnership
通讯作者：
ACCESS-SMC Partnership
影响因子：
3
作者：
Coulibaly, Drissa;Travassos, Mark A.;Thera, Mahamadou A.
通讯作者：
Thera, Mahamadou A.
影响因子：
4.6
作者：
通讯作者：
--
影响因子：
5.5
作者：
Lyke, KE;Dicko, A;Doumbo, OK
通讯作者：
Doumbo, OK