Pilot Study of the Addition of Mass Treatment for Malaria to Existing School-Based Programs to Treat Neglected Tropical Diseases
Pilot Study of the Addition of Mass Treatment for Malaria to Existing School-Based Programs to Treat Neglected Tropical Diseases
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DOI：
10.4269/ajtmh.17-0590
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发表时间：
2018-01-01
影响因子：
3.3
通讯作者：
Laufer, Miriam K.
中科院分区：
文献类型：
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作者：
Cohee, Lauren M.;Chilombe, Moses;Laufer, Miriam K.
疟疾和被忽视的热带病，包括血吸虫病和土壤传播的蠕虫，威胁着撒哈拉以南非洲学龄儿童的健康。建立以学校为基础的大规模药物管理（MDA）计划被用来控制NTD。最近的临床试验表明，在学校大规模治疗疟疾是有益的。在现有NTD方案中增加疟疾治疗的潜力尚未得到彻底评估。我们在常规NTD MDA期间提供蒿甲醚-苯芴醇治疗疟疾，并在马拉维南部的两所小学开展同伴教育计划。我们评估了蒿甲醚-苯芴醇与吡喹酮和阿苯达唑联合给药的参与性、安全性和耐受性。结果进行了比较，两所学校进行标准的NTD MDA与研究人员的额外监测。共有3，387名学生（68%）接受了标准NTD MDA。在MDA当天来到学校的家长中，疟疾治疗被广泛接受;在干预学校接受标准NTD MDA的学生中，87%也同意接受蒿甲醚-苯芴醇治疗。最常见的治疗后出现的不良事件（AE）为头痛和呕吐。然而，AE很罕见，在接受吡喹酮和阿苯达唑加蒿甲醚-苯芴醇的学生中并不更常见。在这项研究中，我们发现在NTD MDA的基础上增加疟疾治疗是受欢迎的和安全的。这种综合方案可以利用现有的基础设施，以减少干预费用，并可能成为进一步综合学校为基础的健康计划的框架。
Malaria and neglected tropical diseases (NTDs), including schistosomiasis and soil transmitted helminths, threaten the health of school aged in sub-Saharan Africa. Established school-based mass drug administration (MDA) programs are used to control NTDs. Recent clinical trials have shown benefit of mass treatment of malaria in schools. The potential of adding malaria treatment to existing NTD programs has not been thoroughly evaluated. We offered malaria treatment with artemether-lumefantrine during routine NTD MDA and developed peer education programs in two primary schools in southern Malawi. We assessed participation, safety, and tolerability of coadministration of artemether-lumefantrine with praziquantel and albendazole. Results were compared with two schools conducting standard NTD MDA with additional monitoring by study staff. A total of 3,387 students (68%) received the standard NTD MDA. Among parents who came to schools on the day of the MDA, malaria treatment was well accepted; 87% of students who received the standard NTD MDA in intervention schools also consented for treatment with artemether-lumefantrine. The most frequent treatment emergent adverse events (AEs) were headache and vomiting. However, AEs were rare and were not more frequent in students who received artemether-lumefantrine in addition to praziquantel and albendazole. In this study, we found that the addition of malaria treatment to NTD MDA is well-received and safe. Such integrated programs may leverage existing infrastructures to reduce intervention costs and could become the framework for further integrated school-based health programs.