A double-blind randomized controlled trial of antenatal mebendazole to reduce low birthweight in a hookworm-endemic area of Peru
A double-blind randomized controlled trial of antenatal mebendazole to reduce low birthweight in a hookworm-endemic area of Peru
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DOI：
10.1111/j.1365-3156.2006.01706.x
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发表时间：
2006-10-01
影响因子：
3.3
通讯作者：
Gyorkos, Theresa W.
中科院分区：
文献类型：
--
作者：
Larocque, Renee;Casapia, Martin;Gyorkos, Theresa W.
旨在评估钩虫高流行地区产前甲苯咪唑加铁与安慰剂加铁对出生体重的影响。在秘鲁亚马逊地区的农村和城郊社区进行双盲、随机对照试验。从2003年4月到11月，总共招募了1042名年龄在18至44岁之间的中期妊娠妇女，并随访至2004年7月。妇女被随机分配接受甲苯咪唑（单剂量500毫克）加铁补充剂（每日60毫克元素铁）或安慰剂加铁补充剂。主要指标是婴儿平均出生体重，次要指标包括低出生体重婴儿比例和孕产妇贫血。钩虫感染率为47.5%。干预组之间的平均出生体重（3104 g vs. 3090 g，P = 0.629）、低出生体重比例（< 2500 g；8.1% vs. 8.7%，P = 0.755）或孕晚期孕产妇贫血的比例没有差异[33.0% (158/479) vs. 32.3% (152/471)，P = 0.815]。然而，甲苯咪唑组极低出生体重（< 1500 g）的比例明显较低[0% (0/479) vs. 1.5% (7/471)，P = 0.007]。该试验为在钩虫流行地区的产前护理计划中除补充铁剂外使用驱虫药提供了额外的证据。在没有产前补铁计划或钩虫感染强度较高的国家，驱虫的益处可能更高。
To assess the effect on birthweight of antenatal mebendazole plus iron vs. placebo plus iron in a highly hookworm-endemic area.Double-blind, randomized controlled trial set in rural and peri-urban communities in the Peruvian Amazon region. A total of 1042 second trimester pregnant women between the ages of 18 and 44 years were recruited from April to November 2003, and followed to July 2004. Women were randomly assigned to receive either mebendazole (500 mg single dose) plus iron supplements (60 mg elemental iron daily) or placebo plus iron supplements. The primary outcome was mean infant birthweight and secondary measures included proportion of low birthweight babies and maternal anaemia.The prevalence of hookworm infection was 47.5%. There were no differences between intervention groups in mean birthweight (3104 g vs. 3090 g, P = 0.629), proportion of low birthweight (< 2500 g; 8.1%vs. 8.7%, P = 0.755) or maternal anaemia in the third trimester [33.0% (158/479) vs. 32.3% (152/471), P = 0.815]. However, the proportion of very low birthweight (< 1500 g) was significantly lower in the mebendazole group [0% (0/479) vs. 1.5% (7/471), P = 0.007].This trial provides additional evidence for the use of anthelmintics, over and above iron supplementation, within antenatal care programmes in hookworm-endemic areas. Benefits of de-worming may be higher in countries not having an antenatal iron supplementation programme or where intensity of hookworm infections is higher.