Impact of intermittent preventive treatment with dihydroartemisinin-piperaquine on malaria in Ugandan schoolchildren: a randomized, placebo-controlled trial.
Impact of intermittent preventive treatment with dihydroartemisinin-piperaquine on malaria in Ugandan schoolchildren: a randomized, placebo-controlled trial.
复制标题
DOI：
10.1093/cid/ciu150
复制
发表时间：
2014-05
期刊：
影响因子：
--
通讯作者：
Kamya MR
中科院分区：
文献类型：
--
作者：
Nankabirwa JI;Wandera B;Amuge P;Kiwanuka N;Dorsey G;Rosenthal PJ;Brooker SJ;Staedke SG;Kamya MR
每月服用一次双氢青蒿素-哌喹，而不是每学期服用一次，是预防生活在高传播环境中的学龄儿童疟疾发病率、寄生虫血症流行率和贫血流行率的一项非常有效的措施。背景：对在校儿童进行间歇性预防性治疗（IPT）为疟疾控制提供了一个有希望的选择。 然而，IPT的最佳药物和给药方案仍有待确定。方法：我们对740名6-14岁的学龄儿童进行了一项随机、双盲、安慰剂对照试验，这些儿童生活在乌干达疟疾高传播地区。 入组儿童随机接受每月一次（IPTm）的双氢青蒿素-哌喹（DP）、每学期一次的DP（12个月内4次治疗，IPTst）或安慰剂，并随访12个月。主要结果是12个月内的疟疾发病率。次要结局包括12个月内的寄生虫患病率和贫血。在意向治疗基础上进行分析。结果：在安慰剂组中，疟疾发病率为0.34次/人年，寄生虫血症和贫血的患病率分别为38%和20%。 IPTm使疟疾发病率降低96%（95%置信区间[CI]，88%-99%，P < .0001），无症状寄生虫血症患病率降低94%（95% CI，92%-96%，P < .0001），贫血患病率降低40%（95% CI，19%-56%，P < .0001）。IPTst对症状性疟疾的发病率或贫血的患病率没有显著影响，但使无症状寄生虫血症的患病率降低了54%（95%CI，47%-60%，P < .0001）。结论：在疟疾高传播环境中，每月一次的IPT联合DP对学龄儿童的临床疟疾、寄生虫血症和贫血有显著的保护作用。 临床试验注册NCT 01231880。
Dihydroartemisinin-piperaquine administered at monthly intervals, but not that dosed once a school term, is a remarkably effective measure for the prevention of incidence of malaria, prevalence of parasitemia, and prevalence of anemia in schoolchildren living in a high-transmission setting. Background. Intermittent preventive treatment (IPT) in schoolchildren offers a promising option for malaria control. However, the optimal drug and dosing regimens for IPT remain to be determined. Methods. We conducted a randomized, double-blind, placebo-controlled trial in 740 schoolchildren aged 6–14 years living in a setting of high malaria transmission in Uganda. Enrolled children were randomized to dihydroartemisinin-piperaquine (DP) given once a month (IPTm), DP given once a school term (4 treatments over 12 months, IPTst), or placebo and followed for 12 months. The primary outcome was the incidence of malaria over 12 months. Secondary outcomes included parasite prevalence and anemia over 12 months. Analyses were conducted on an intention-to-treat basis. Results. In the placebo arm, the incidence of malaria was 0.34 episodes per person-year and the prevalence of parasitemia and anemia was 38% and 20%, respectively. IPTm reduced the incidence of malaria by 96% (95% confidence interval [CI], 88%–99%, P < .0001), the prevalence of asymptomatic parasitemia by 94% (95% CI, 92%–96%, P < .0001), and the prevalence of anemia by 40% (95% CI, 19%–56%, P < .0001). IPTst had no significant effect on the incidence of symptomatic malaria or the prevalence of anemia, but reduced the prevalence of asymptomatic parasitemia by 54% (95% CI, 47%–60%, P < .0001). Conclusions. Monthly IPT with DP offered remarkable protection against clinical malaria, parasitemia, and anemia in schoolchildren living in a high-malaria-transmission setting. Clinical Trials Registration. NCT01231880.
登录
查看更多内容
影响因子：
4.9
作者：
Lwin, Khin Maung;Phyo, Aung Pyae;Nosten, Francois
通讯作者：
Nosten, Francois
DOI：
10.1371/journal.pctr.0020020
发表时间：
2007-05-18
期刊：
PLoS clinical trials
影响因子：
--
作者：
Kamya, Moses R;Yeka, Adoke;Dorsey, Grant
通讯作者：
Dorsey, Grant
影响因子：
4.9
作者：
Tarning, J.;Ashley, E. A.;White, N. J.
通讯作者：
White, N. J.
影响因子：
168.9
作者：
Gosling, Roly D.;Gesase, Samwel;Chandramohan, Daniel
通讯作者：
Chandramohan, Daniel
影响因子：
3.3
作者：
Barger, Breanna;Maiga, Hamma;Djimde, Abdoulaye A.
通讯作者：
Djimde, Abdoulaye A.