Options for the Delivery of Intermittent Preventive Treatment for Malaria to Children: A Community Randomised Trial
Options for the Delivery of Intermittent Preventive Treatment for Malaria to Children: A Community Randomised Trial
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DOI：
10.1371/journal.pone.0007256
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发表时间：
2009-09-30
期刊：
影响因子：
3.7
通讯作者：
Chandramohan, Daniel
中科院分区：
文献类型：
--
作者：
Kweku, Margaret;Webster, Jayne;Chandramohan, Daniel
背景：儿童疟疾间歇性预防治疗（IPTc）是一种很有前途的预防疟疾的新干预措施，但其实施是一个挑战。我们评估了加纳两种不同的提供系统可以实现的 IPTc 覆盖范围。 方法：IPTc 由六个村庄的志愿者（基于社区的部门）以及卫生中心或扩大免疫外展计划诊所（基于设施）的卫生工作者在另外六个社区提供。随机选择村庄，并于 2006 年 5 月、6 月、9 月和 10 月进行给药。在监督下，对 12 个研究村庄的 3-59 个月大的儿童（n=964）进行了阿莫地喹加磺胺多辛-乙胺嘧啶三剂量方案的第一剂给药；第 2 天和第 3 天的剂量由家长/监护人在家中服用。 结果：在社区组中，至少接受 3 个或更多疗程 IPTc 的第一剂的儿童比例略高（90.5% vs 86.6%；p=0.059）。两种给药系统的三种剂量方案的完成率都很高且相似（分别为 91.6% 和 91.7%）。结论：通过社区或设施系统提供的季节性 IPTc 在区卫生管理团队的支持和监督下可以实现较高的覆盖率。然而，为了最大限度地发挥 IPTc 的影响，在某些情况下可能需要两种传输系统。
Background: Intermittent preventive treatment for malaria in children (IPTc) is a promising new intervention for the prevention of malaria but its delivery is a challenge. We have evaluated the coverage of IPTc that can be achieved by two different delivery systems in Ghana.Methods: IPTc was delivered by volunteers in six villages (community-based arm) and by health workers at health centres or at Expanded Programme on Immunisation outreach clinics (facility based) in another six communities. The villages were selected randomly and drugs were administered in May, June, September and October 2006. The first dose of a three-dose regimen of amodiaquine plus sulphadoxine-pyrimethamine was administered under supervision to 3-59 month-old children (n=964) in the 12 study villages; doses for days 2 and 3 were given to parents/guardians to administer at home.Results: The proportion of children who received at least the first dose of 3 or more courses of IPTc was slightly higher in the community based arm (90.5% vs 86.6%; p=0.059). Completion of the three dose regimen was high and similar with both delivery systems (91.6% and 91.7% respectively).Conclusion: Seasonal IPTc delivered through community-based or facility-based systems can achieve a high coverage rate with the support and supervision of the district health management team. However, in order to maximise the impact of IPTc, both delivery systems may be needed in some settings.