Effect of routine seasonal malaria chemoprevention on malaria trends in children under 5 years in Dangassa, Mali
Effect of routine seasonal malaria chemoprevention on malaria trends in children under 5 years in Dangassa, Mali
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DOI：
10.1186/s12936-020-03202-y
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发表时间：
2020-04-06
期刊：
影响因子：
3
通讯作者：
Diakite, Mahamadou
中科院分区：
文献类型：
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作者：
Konate, Drissa;Diawara, Sory, I;Diakite, Mahamadou
背景季节性疟疾化学预防（SMC）是预防5岁以下儿童疟疾的新策略。自2012年以来，世界卫生组织一直建议在季节性传播的疟疾流行地区接种疫苗。本研究旨在通过对丹加萨省5岁以下儿童连续两年常规实施SMC来评估疟疾指标的变化。丹加萨省疟疾流行，传播季节长且高。方法2012 - 2016年在丹加萨村进行队列研究。设在该村的研究小组跟踪了社区保健中心5岁以下儿童的所有疟疾临床病例。在研究期间，与国家疟疾控制规划合作，定期实施了SMC。为了比较研究期间的疟疾风险，使用了Cox回归模型。结果Cox回归模型显示，与2013年10月相比，2015年（HR = 0.27 (0.18-0.40), 95% CI）和2016年(HR = 0.23(0.15-0.35)，疟疾临床发病率均显著降低。与SMC实施前同期（2013-2014）相比，SMC实施期间（2015年和2016年）9月至10月的配子细胞和发热患病率较低。12月，在SMC实施结束时，观察到疟疾发病率略有增加。结论SMC在常规实施2年后，显著降低了5岁以下儿童的疟疾发病率和配子体患病率，改善了血红蛋白水平。
Background Seasonal malaria chemoprevention (SMC) is a new strategy to prevent malaria in children under 5 years old. It has been recommended by the World Health Organization since 2012 in malaria-endemic areas with seasonal transmission. This study aimed to assess the changes in malaria indicators through two consecutive years of SMC routine implementation in children under 5 years old in Dangassa, where malaria is endemic with a long and high transmission season. Methods From 2012 to 2016, a cohort study was conducted in Dangassa village. The study team based in the village followed all malaria clinical cases in children under 5 years old at the community health centre. During the study, SMC was routinely implemented in collaboration with the National Malaria Control Programme. The Cox regression model was used in order to compare malaria risk during the study. Results The Cox regression model showed a significant reduction in malaria clinical incidence, both in 2015 (HR = 0.27 (0.18-0.40), 95% CI) and in 2016 (HR = 0.23 (0.15-0.35), 95% CI) of SMC implementation compared to October 2013. Gametocyte and fever prevalence was lower between September and October during SMC implementation (2015 and 2016) compared to the same period before SMC implementation (2013-2014). A slight increase of malaria incidence was observed in December at the end of SMC implementation. Conclusion SMC has significantly reduced both malaria incidence and gametocyte prevalence and improved haemoglobin levels in children under 5 years old after 2 years of routine implementation.