Effect of seasonal malaria chemoprevention in children between 5 and 9 years old in Kita and Bafoulabe districts, Mali.
Effect of seasonal malaria chemoprevention in children between 5 and 9 years old in Kita and Bafoulabe districts, Mali.
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DOI：
10.1016/j.parepi.2022.e00258
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发表时间：
2022-08
影响因子：
3.2
通讯作者：
Eckert, Erin
中科院分区：
文献类型：
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作者：
Diawara, Sory Ibrahima;Konate, Drissa;Kayentao, Kassoum;Mihigo, Jules;Shaffer, Jeffrey G.;Sangare, Modibo;Ndabamenye, Protais;Swedberg, Eric;Garg, Lyndsey W.;Gamache, Nathalie;Keita, Bourama;Kamate, Beh;Ndaruhutse, Philbert;Kone, Diakalia;Sanogo, Vincent;Tounkara, Moctar;Diakite, Mahamadou;Doumbia, Seydou;Eckert, Erin
自 2012 年世界卫生组织推荐以来，季节性疟疾化学预防 (SMC) 已在马里广泛推广。SMC 指南目前针对三个月至五岁的儿童。 SMC 举措已基本取得成功。目前，当前的 SMC 指南并未涵盖五岁以上的儿童，但他们承担了相当大一部分疟疾负担。因此，本研究试图确定将 SMC 扩展到 5-9 岁儿童的可行性和有效性。在干预区（Kita）和比较区（Bafoulabe）中进行了一项非随机的事前研究。 3-59 个月的儿童在两个比较区都接受了 SMC，60-120 个月的儿童在干预区接受了 SMC。在历史传播季节，2017 年和 2018 年 7 月至 10 月期间，SMC 以磺胺多辛-乙胺嘧啶加阿莫地喹 (SP-AQ) 的形式按月交付。在两个比较区都进行了基线和终点横断面调查。在四个月的 SMC 周期中，每个周期进行了总共 200 次家庭调查，以确定干预区对 SMC 的依从性和耐受性。 2017 年 7 月，Kita 和 Bafoulabe 研究中心招募了 633 名 60-120 个月大的儿童（分别为 310 名和 323 名）。 SMC 运动之前的干预区和比较区的寄生虫血症患病率相似（27.7% 与 21.7%，p = 0.07）。基塔地区 14.2% 的儿童和巴富拉贝地区 10.5% 的儿童出现轻度贫血。在北区，家庭调查显示 SMC 覆盖率为 89.1%，儿童看护者的回应率为 93.3%。家长报告的最常见不良事件是嗜睡（11.8%）。在北区老年组实施 SMC 一年后，每轮三剂的覆盖率为 81.2%。在基线调查和最终调查之间，寄生虫血症患病率降低了 40%（OR = 0.60，CI：0.41–0.89）。干预后，干预区的疟疾分子耐药性较低。在干预区，60 至 120 个月儿童的寄生虫血症患病率显着下降，但临床疟疾的患病率保持相对稳定。这项研究表明，将 SMC 覆盖范围扩大到 5 至 9 岁儿童的前景令人鼓舞。寄生虫血症的减少也值得考虑调整 SMC 政策，以应对疟疾传播季节延长的情况。
Seasonal malaria chemoprevention (SMC) has been widely expanded in Mali since its recommendation by the the World Health Organization in 2012. SMC guidelines currently target children between three months and five years of age. The SMC initiative has been largely successful. Children at least five years of age are not currently covered by current SMC guidelines but bear a considerable portion of the malaria burden. For this reason, this study sought to determine the feasibility and effectiveness for extending SMC to children aged 5–9 years. A non-randomized, pre-post study was performed with an intervention district (Kita) and a comparison district (Bafoulabe). Children aged 3–59 months received SMC in both comparison districts, and children aged 60–120 months received SMC in the intervention district. SMC was delivered as sulfadoxine-pyriméthamine plus amodiaquine (SP-AQ) at monthly intervals from July to October in 2017 and 2018 during the historical transmission seasons. Baseline and endline cross-sectional surveys were conducted in both comparison districts. A total of 200 household surveys were conducted at each of the four monthly SMC cycles to determine adherence and tolerance to SMC in the intervention district. In July 2017, 633 children aged 60–120 months old were enrolled at the Kita and Bafoulabe study sites (n = 310 and n = 323, respectively). Parasitemia prevalence was similar in the intervention and comparison districts prior the SMC campaign (27.7% versus 21.7%, p = 0.07). Mild anemia was observed in 14.2% children in Kita and in 10.5% of children in Bafoulabé. At the Kita site, household surveys showed an SMC coverage rate of 89.1% with a response rate of 93.3% among child caregivers. The most common adverse event reported by parents was drowsiness (11.8%). One year following SMC implementation in the older age group in Kita, the coverage of three doses per round was 81.2%. Between the baseline and endline surveys, there was a reduction in parasitemia prevalence of 40% (OR = 0.60, CI: 0.41–0.89). Malaria molecular resistance was low in the intervention district following the intervention. A significant reduction in the prevalence of parasitemia in children 60 to 120 months was observed in the intervention district, but the prevalance of clinical malaria remained relatively constant. This study shows that the prospect of extending SMC coverage to children between five and nine years old is encouraging. The reduction in the parasitemia could also warrant consideration for adapting SMC policy to account for extended malaria transmission seasons.
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DOI：
10.3390/ijerph17186639
发表时间：
2020-09-11
影响因子：
--
作者：
Maiga H;Gaudart J;Sagara I;Diarra M;Bamadio A;Djimde M;Coumare S;Sangare B;Dicko Y;Tembely A;Traore D;Dicko A;Lasry E;Doumbo O;Djimde AA
通讯作者：
Djimde AA
影响因子：
3.3
作者：
Barger, Breanna;Maiga, Hamma;Djimde, Abdoulaye A.
通讯作者：
Djimde, Abdoulaye A.
影响因子：
2.5
作者：
Ndiaye, Jean-Louis A.;Diallo, Ibrahima;Milligan, Paul
通讯作者：
Milligan, Paul
影响因子：
15.8
作者：
Bojang, Kalifa A.;Akor, Francis;Greenwood, Brian
通讯作者：
Greenwood, Brian
影响因子：
3.7
作者：
Bojang, Kalifa;Akor, Francis;Greenwood, Brian
通讯作者：
Greenwood, Brian