Impact of permethrin-treated bed nets on malaria and all-cause morbidity in young children in an area of intense perennial malaria transmission in western Kenya: Cross-sectional survey
Impact of permethrin-treated bed nets on malaria and all-cause morbidity in young children in an area of intense perennial malaria transmission in western Kenya: Cross-sectional survey
复制标题
DOI：
10.4269/ajtmh.2003.68.100
复制
发表时间：
2003-04-01
影响因子：
3.3
通讯作者：
Nahlen, BL
中科院分区：
文献类型：
--
作者：
ter Kuile, FO;Terlouw, DJ;Nahlen, BL
在疟疾常年传播严重地区进行的随机对照试验中，关于杀虫剂（氯菊酯）处理过的蚊帐的影响的信息有限。在肯尼亚西部一个完全流行的地区，作为一项关于驱虫蚊帐对儿童死亡率影响的大规模、以社区为基础、分组随机对照试验的一部分，我们在60个村庄进行了三次横断面调查，以评估驱虫蚊帐对1,890名三岁以下儿童发病率的影响。经杀虫剂处理过的蚊帐和对照村的儿童在干预前相当，但在引入经杀虫剂处理过的蚊帐后，干预村的儿童最近出现需要治疗的疾病的可能性较小（保护效力[95%置信区间] = 15% [1-26%]），脾脏增大（32% [20-43%]），寄生虫血症（19% [11-27%]），患有临床疟疾（44% [6-66%]），中度重度贫血（血红蛋白水平< 7.0 g/dL; 39% [18-54%]），或有过敏性身体皮疹，可能是由于讨厌的昆虫叮咬减少（38% [24-50%]）。使用驱虫蚊帐还与显著较高的平均年龄别体重Z评分和中上臂围相关。然而，没有证据表明驱虫蚊帐能降低蠕虫感染、腹泻或上呼吸道或下呼吸道感染的风险。驱虫蚊帐大大降低了这一疟疾常年传播密集地区与疟疾有关的发病率，并改善了幼儿体重增加的情况。
Information on the impact of insecticide (permethrin)-treated bed nets (ITNs) from randomized controlled trials in areas of intense perennial malaria transmission is limited. As part of a large-scale, community-based, group-randomized controlled trial of the effect of ITNs on childhood mortality in a holoendemic area in western Kenya, we conducted three cross-sectional surveys in 60 villages to assess the impact of ITNs on morbidity in 1,890 children less than three years old. Children in ITN and control villages were comparable pre-intervention, but after the introduction of ITNs, children in intervention villages were less likely to have recently experienced illness requiring treatment (protective efficacy [95% confidence intervals] = 15% [1-26%]), have an enlarged spleen (32% [20-43%]), be parasitemic (19% [11-27%]), have clinical malaria (44% [6-66%]), have moderately severe anemia (hemoglobin level < 7.0 g/dL; 39% [18-54%]), or have a pruritic body rash, presumably from reduced nuisance insect bites (38% [24-50%]). Use of ITNs was also associated with significantly higher mean weight-for-age Z-scores and mid-upper arm circumferences. There was no evidence, however, that ITNs reduced the risk of helminth infections, diarrhea, or upper or lower respiratory tract infections. The ITNs substantially reduced malaria-associated morbidity and improved weight gain in young children in this area of intense perennial malaria transmission.