Mass Drug Administration With Dihydroartemisinin-piperaquine and Malaria Transmission Dynamics in The Gambia: A Prospective Cohort Study.
Mass Drug Administration With Dihydroartemisinin-piperaquine and Malaria Transmission Dynamics in The Gambia: A Prospective Cohort Study.
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DOI：
10.1093/cid/ciy870
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发表时间：
2019-07-02
期刊：
影响因子：
--
通讯作者：
D'Alessandro U
中科院分区：
文献类型：
--
作者：
Mwesigwa J;Achan J;Affara M;Wathuo M;Worwui A;Mohammed NI;Kanuteh F;Prom A;Dierickx S;di Tanna GL;Nwakanma D;Bousema T;Drakeley C;Van Geertruyden JP;D'Alessandro U
大规模药物管理（MDA）可能会进一步减少低传播地区的疟疾传播。一项前瞻性队列研究确定了 MDA 对疟疾传播动态的影响。 2014 年和 2015 年，在疟疾传播季节之前，在 6 对村庄实施了年度双氢青蒿素哌喹 (DP) MDA。 7 月至 12 月期间从居民那里采集血样进行显微镜检查和巢式 PCR。确定了 MDA 后感染的发生率和患病率、临床疾病以及疟疾再次感染的风险。三种 DP 剂量的覆盖率分别为 68.2%（2014 年）和 65.6%（2015 年），依从性大于 80%。 2014 年感染发生率（发病率 [IR] = 0.2 每人年 [PPY]）明显低于 2013 年（IR = 1.1 PPY；P < .01）； MDA 后的前三个月内，每月感染率有所下降。 2014 年 (IR = 0.1 PPY) 和 2015 年 (IR = 0.2 PPY) 的临床疟疾发病率低于 2013 年 (IR = 0.4 PPY；P < .01)，但冈比亚东部的发病率仍然较高。 MDA 之前感染的个体在 MDA 后再次感染的几率高出 2 倍（调整后的优势比 = 2.5，95% 置信区间 1.5–4.3；P < .01）。 MDA 在最初几个月内减少了疟疾感染和临床疾病。低传播率地区仍保持下降趋势，但冈比亚东部则不然。年度 MDA 之后可以针对旱季感染个体进行重点 MDA。重复的 MDA 轮次（其中一些轮次是在旱季在更大的地理区域进行）可能会导致疟疾传播更加显着和持续的减少。两年多以来，每年使用双氢青蒿素-哌喹进行大规模用药（MDA）减少了疟疾感染和临床疾病的发生率，但在冈比亚东部并没有持续下去。大面积的多轮 MDA 可能会导致更大规模、持续的传播减少。
Mass drug administration (MDA) may further reduce malaria transmission in low-transmission areas. The impact of MDA on the dynamics of malaria transmission was determined in a prospective cohort study. Annual rounds of MDA with dihydroartemisinin-piperaquine (DP) were implemented were implemented in 2014 and 2015 in six village pairs before the malaria transmission season. Blood samples were collected from residents between July and December for microscopy and nested PCR. Incidence and prevalence of infection, clinical disease, and risk of malaria reinfection post-MDA were determined. Coverage of three DP doses was 68.2% (2014) and 65.6% (2015), compliance was greater than 80%. Incidence of infection was significantly lower in 2014 (incidence rate [IR] = 0.2 per person year [PPY]) than in 2013 (IR = 1.1 PPY; P < .01); monthly infection prevalence declined in the first three months post-MDA. Clinical malaria incidence was lower in 2014 (IR = 0.1 PPY) and 2015 (IR = 0.2 PPY) than in 2013 (IR = 0.4 PPY; P < .01), but remained higher in eastern Gambia. Individuals infected before MDA had a 2-fold higher odds of reinfection post-MDA (adjusted odds ratio = 2.5, 95% confidence interval 1.5–4.3; P < .01). MDA reduced malaria infection and clinical disease during the first months. The reduction was maintained in low-transmission areas, but not in eastern Gambia. Annual MDA could be followed by focal MDA targeting individuals infected during the dry season. Repeated MDA rounds, some during the dry season over larger geographical areas, may result in a more marked and sustained decrease of malaria transmission. Annual mass drug administration (MDA) with dihydroartemisinin-piperaquine over 2 years reduced the incidence of malaria infection and clinical disease, but was not sustained in eastern Gambia. Multiple MDA rounds over large areas may result in larger and sustained transmission reductions.
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DOI：
10.1016/s1473-3099(16)30378-4
发表时间：
2017-02
期刊：
The Lancet. Infectious diseases
影响因子：
--
作者：
Gutman J;Kovacs S;Dorsey G;Stergachis A;Ter Kuile FO
通讯作者：
Ter Kuile FO
影响因子：
3
作者：
Satoguina, Judith;Walther, Brigitte;Walther, Michael
通讯作者：
Walther, Michael
影响因子：
--
作者：
Landier J;Kajeechiwa L;Thwin MM;Parker DM;Chaumeau V;Wiladphaingern J;Imwong M;Miotto O;Patumrat K;Duanguppama J;Cerqueira D;Malleret B;Rénia L;Nosten S;von Seidlein L;Ling C;Proux S;Corbel V;Simpson JA;Dondorp AM;White NJ;Nosten FH
通讯作者：
Nosten FH
影响因子：
3.7
作者：
Dierickx S;Gryseels C;Mwesigwa J;O'Neill S;Bannister-Tyrell M;Ronse M;Jaiteh F;Gerrets R;D'Alessandro U;Grietens KP
通讯作者：
Grietens KP
影响因子：
3.7
作者：
Okebe, Joseph;Affara, Muna;D'Alessandro, Umberto
通讯作者：
D'Alessandro, Umberto