Effects of insecticide-treated bednets during early infancy in an African area of intense malaria transmission: a randomized controlled trial
Effects of insecticide-treated bednets during early infancy in an African area of intense malaria transmission: a randomized controlled trial
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DOI：
10.2471/blt.05.023150
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发表时间：
2006-02-01
期刊：
影响因子：
--
通讯作者：
Becher, Heiko
中科院分区：
文献类型：
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作者：
Müller, Olaf;Traoré, Corneille;Becher, Heiko
目的许多研究表明，经杀虫剂浸渍的蚊帐和窗帘对防治疟疾有效。然而，由于可能与免疫发育相互作用，处理过的蚊帐可能根本不起作用，甚至在高传播地区增加疟疾发病率和死亡率。为了澄清这个问题，我们做了一项随机对照试验来评估婴儿早期蚊帐保护的长期效果。方法将布基纳法索41个村庄的3387名新生儿随机分为两组，一组从出生时开始使用蚊帐，另一组从6个月开始使用蚊帐。主要结局是所有研究儿童的全因死亡率和研究人群中代表性亚样本的恶性疟疾发病率。结果平均随访27个月后，a组死亡129例，B组死亡128例，死亡率比（RR） 1.0（95%可信区间（CI）： 0.78 ~ 1.27）。在婴儿期早期（0-5个月）和晚期（6-12个月），A组的恶性疟疾发病率低于B组（RR 3.1, 95% CI: 2.0-4.9; RR 1.3, 95% Cl: 1.1-1.6），婴儿期晚期的中度至重度贫血率显著低于B组（11.5% vs 23.3%, P = 0.008），但在12个月以上儿童中，这些参数在组间无差异。结论本研究结果为驱虫蚊帐对生活在疟疾严重传播地区的幼儿的有效性提供了额外证据。
Objective Insecticide-impregnated bednets and curtains have been shown by many studies to be effective against malaria. However, because of possible interactions with immunity development, treated bednets may cause no effect at all or even an increase in malaria morbidity and mortality in areas of high transmission. To clarify this issue, we did a randomized controlled trial to assess the long-term effects of bednet protection during early infancy.Methods A total of 3387 neonates from 41 villages in rural Burkina Faso were individually randomized to receive either bednet protection from birth (group A) or from age 6 months (group B). Primary outcomes were all-cause mortality in all study children and incidence of falciparum malaria in a representative subsample of the study population.Findings After a mean follow-up of 27 months, there were 129 deaths in group A and 128 deaths in group B rate ratio (RR) 1.0 (95% confidence interval (CI): 0.78-1.27)). Falciparum malaria incidence was lower in group A than in group B, during early (0-5 months) and late infancy (6-12 months) (RR 3.1, 95% CI: 2.0-4.9; RR 1.3, 95% Cl: 1.1-1.6) and rates of moderate to severe anaemia were significantly lower during late infancy (11.5% vs 23.3%, P = 0.008), but there were no differences between groups in these parameters in children older than 12 months.Conclusion The findings from this study provide additional evidence for the efficacy of insecticide-treated nets in young children living in areas of intense malaria transmission.