Feasibility, safety and effectiveness of combining home based malaria management and seasonal malaria chemoprevention in children less than 10 years in Senegal: a cluster-randomised trial
Feasibility, safety and effectiveness of combining home based malaria management and seasonal malaria chemoprevention in children less than 10 years in Senegal: a cluster-randomised trial
复制标题
DOI：
10.1093/trstmh/trt103
复制
发表时间：
2014-01-01
影响因子：
2.2
通讯作者：
Gaye, Oumar
中科院分区：
文献类型：
--
作者：
Tine, Roger C. K.;Ndour, Cheikh T.;Gaye, Oumar
以家庭为基础的疟疾管理(HMM)可改善获得诊断检测和青蒿素联合疗法(ACT)治疗的机会。在萨赫勒地区，现在建议采用季节性疟疾化学预防措施(SMC)预防儿童疟疾。联合使用抗疟疾干预措施很可能会减轻疟疾负担。这项研究评估了由社区卫生工作者(CHW)提供的SMC和HMM相结合的可行性、有效性和安全性。在塞内加尔东南部的8个村庄进行了两个传播季节的整群随机试验。干预社区接受HMMSMC，对照社区接受HMM。主要终点是随访期间疟疾发作的发生率。次级终点包括：疟疾诊断准确性；获得ACT治疗的机会；SMC覆盖率；安全性和药物耐受性。干预和对照社区疟疾发作的调整比率为0.15，表明HMMSMC的保护效果为85(95CI：39.996.3，p0.01)。2010年，获得抗癌药物治疗的人数为96.4%，而中小规模医疗保险覆盖率为97.3%(95CI：91.3100)，2011年为88.8%(95CI：84.293.6)。未记录严重不良事件。将SMC与HMM干预相结合似乎是可行和安全的，同时实现SMC和HMM的高覆盖率和有效性。(www.pactr.org)PACTR201305000551876。
Home-based management of malaria (HMM) may improve access to diagnostic testing and treatment with artemisinin combination therapy (ACT). In the Sahel region, seasonal malaria chemoprevention (SMC) is now recommended for the prevention of malaria in children. It is likely that combinations of antimalarial interventions can reduce the malaria burden. This study assessed the feasibility, effectiveness and safety of combining SMC and HMM delivered by community health workers (CHWs).A cluster-randomised trial was carried out during two transmission seasons in eight villages located in the south-eastern part of Senegal. Intervention communities received HMMSMC while control communities received HMM. Primary end point was the incidence of malaria attacks during the follow up period. Secondary end points included: malaria diagnostic accuracy; access to ACT treatment; SMC coverage; safety and drug tolerability.The adjusted rate ratio for incidence of malaria attacks in intervention and control communities was 0.15, indicating a protective effect of HMMSMC of 85 (95 CI: 39.996.3, p0.01). Access to ACT treatment was 96.4 while SMC coverage represented 97.3 (95 CI: 91.3100) in 2010, and 88.8 (95 CI: 84.293.6) in 2011. No serious adverse events were recorded.It seems feasible and safe to combine SMC with HMM intervention, while achieving high coverage and effectiveness of both SMC and HMM.(www.pactr.org) PACTR201305000551876.