Short-term Impact of Mass Drug Administration With Dihydroartemisinin Plus Piperaquine on Malaria in Southern Province Zambia: A Cluster-Randomized Controlled Trial.
Short-term Impact of Mass Drug Administration With Dihydroartemisinin Plus Piperaquine on Malaria in Southern Province Zambia: A Cluster-Randomized Controlled Trial.
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DOI：
10.1093/infdis/jiw416
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发表时间：
2016-12-15
期刊：
影响因子：
--
通讯作者：
Miller JM
中科院分区：
文献类型：
--
作者：
Eisele TP;Bennett A;Silumbe K;Finn TP;Chalwe V;Kamuliwo M;Hamainza B;Moonga H;Kooma E;Chizema Kawesha E;Yukich J;Keating J;Porter T;Conner RO;Earle D;Steketee RW;Miller JM
使用双氢青蒿素加哌喹（DHAp）的大规模给药（MDA）是清除恶性疟原虫感染和减少人体寄生虫宿主的潜在策略。在赞比亚南部省进行的一项随机分组对照试验被用来评估两轮社区范围的MDA和家庭水平（焦点）MDA与DHAp相比没有大规模治疗的短期影响。研究终点包括儿童寄生虫感染率、感染率和确诊疟疾病例发生率。干预后所有终点均显著降低，与治疗组无关。在低传播地区，寄生虫患病率从基线时的7.71%降至MDA后的0.54%，与对照组相比降低了87%（调整后的比值比为0.13; 95%置信区间为0.02 - 0.92;P = 0.04）。在高传播区域未观察到治疗组之间的差异。与对照组相比，在低传播区和高传播区，MDA后5个月累积感染发生率分别降低70%（粗发生率比，0.30; 95%置信区间，0.06 -1.49; P = 0.14）和58%（0.42; 0.18 - 0.98;P = 0.046）。对于任何终点，均未观察到局灶性MDA的显著影响。两轮MDA联合DHAp迅速降低了感染流行率、感染发病率和确诊病例发病率，特别是在低传播地区。NCT 02329301。
Mass drug administration (MDA) using dihydroartemisinin plus piperaquine (DHAp) represents a potential strategy to clear Plasmodium falciparum infections and reduce the human parasite reservoir. A cluster-randomized controlled trial in Southern Province, Zambia, was used to assess the short-term impact of 2 rounds of community-wide MDA and household-level (focal) MDA with DHAp compared with no mass treatment. Study end points included parasite prevalence in children, infection incidence, and confirmed malaria case incidence. All end points significantly decreased after intervention, irrespective of treatment group. Parasite prevalence from 7.71% at baseline to 0.54% after MDA in lower-transmission areas, resulting in an 87% reduction compared with control (adjusted odds ratio, 0.13; 95% confidence interval, .02–.92;P = .04). No difference between treatment groups was observed in areas of high transmission. The 5-month cumulative infection incidence was 70% lower (crude incidence rate ratio, 0.30; 95% confidence interval, .06–1.49; P = .14) and 58% lower (0.42; .18–.98;P = .046) after MDA compared with control in lower- and higher-transmission areas, respectively. No significant impact of focal MDA was observed for any end point. Two rounds of MDA with DHAp rapidly reduced infection prevalence, infection incidence, and confirmed case incidence rates, especially in low-transmission areas. NCT02329301.
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影响因子：
3
作者：
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