Effectiveness of combined intermittent preventive treatment for children and timely home treatment for malaria control
Effectiveness of combined intermittent preventive treatment for children and timely home treatment for malaria control
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DOI：
10.1186/1475-2875-8-292
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发表时间：
2009-12-11
期刊：
影响因子：
3
通讯作者：
Weiss, Mitchell G.
中科院分区：
文献类型：
--
作者：
Ahorlu, Collins K.;Koram, Kwadwo A.;Weiss, Mitchell G.
背景资料：在等待有效和负担得起的疟疾疫苗到来的同时，有必要利用现有的控制工具来减少疟疾风险，特别是五岁以下儿童和孕妇的风险。间歇性预防性治疗最近被接受为疟疾控制战略的一个重要组成部分。本研究探讨了潜在的战略，间歇性预防性治疗儿童（IPTC）和疟疾相关的发热性疾病在家里及时治疗，减少寄生虫的流行和疟疾发病率在幼儿在沿海村庄在Ghana.Methods：该研究结合了家庭为基础的交付IPTC 6至60个月的年龄和家庭治疗的可疑发热性疟疾疾病在24小时内。所有6至60个月的儿童都接受了阿莫地喹和青蒿琥酯的间歇性预防治疗，由社区助理每4个月提供一次（12个月内提供3次）。在第一剂IPTC之前和第三剂IPTC之后进行疟疾寄生虫患病率调查。结果：两种干预措施开始后一年，寄生虫患病率从25%降低到3%（p < 0.00，Mann-Whitney）。基线时，13.8%的儿童发热（腋窝温度大于或等于37.5 ℃），而评价时为2.2%（IPTC 3后结合及时的发热家庭管理）（p < 0.00，Mann-Whitney）。评价结果表明，IPTC一年三次，结合及时治疗发热性疟疾，对寄生虫的流行有重大影响。这一战略显著降低了寄生虫流行率，表明有可能降低与疟疾有关的儿童发病率和死亡率，防治方案管理人员应对此进行探讨。
Background: Whiles awaiting for the arrival of an effective and affordable malaria vaccine, there is a need to make use of the available control tools to reduce malaria risk, especially in children under five years and pregnant women. Intermittent preventive treatment (IPT) has recently been accepted as an important component of the malaria control strategy. This study explored the potential of a strategy of intermittent preventive treatment for children (IPTC) and timely treatment of malaria-related febrile illness in the home in reducing the parasite prevalence and malaria morbidity in young children in a coastal village in Ghana.Methods: The study combined home-based delivery of IPTC among six to 60 months old and home treatment of suspected febrile malaria illness within 24 hours. All children between six and 60 months of age received intermittent preventive treatment using amodiaquine and artesunate, delivered by community assistants every four months (three times in 12 months). Malaria parasite prevalence surveys were conducted before the first and after the third dose of IPTC.Results: Parasite prevalence was reduced from 25% to 3% (p < 0.00, Mann-Whitney) one year after the inception of the two interventions. At baseline, 13.8% of the children were febrile (axillary temperature greater than or equal to 37.5 degree Celsius) compared to 2.2% at evaluation (post IPTC3 combined with timely home management of fever) (p < 0.00, Mann-Whitney).Conclusion: The evaluation result indicates that IPTC given three times in a year combined with timely treatment of febrile malaria illness, impacts significantly on the parasite prevalence. The marked reduction in the parasite prevalence with this strategy points to the potential for reducing malaria-related childhood morbidity and mortality, and this should be explored by control programme managers.