Intermittent preventive treatment using artemisinin-based combination therapy reduces malaria morbidity among school-aged children in Mali
Intermittent preventive treatment using artemisinin-based combination therapy reduces malaria morbidity among school-aged children in Mali
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DOI：
10.1111/j.1365-3156.2009.02294.x
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发表时间：
2009-07-01
影响因子：
3.3
通讯作者：
Djimde, Abdoulaye A.
中科院分区：
文献类型：
--
作者：
Barger, Breanna;Maiga, Hamma;Djimde, Abdoulaye A.
目的评价间歇性预防治疗（IPT）对学龄儿童疟疾的有效性。方法在马里Kolle进行了一项6-13岁学龄儿童季节性IPT（IPTsc）的开放随机对照试验。该研究于2007年9月开始，并于2008年5月完成随访。学生被随机分配到三个研究组中的一个：磺胺嘧啶-乙胺嘧啶+青蒿琥酯（SP/AS），阿莫地喹+青蒿琥酯（AQ/AS）或维生素C。所有学生都接受了两次完整的治疗剂量，在9月至12月的高传播季节间隔2个月。比较各组的临床疟疾发病率、无症状寄生虫血症和血红蛋白浓度。结果共有296名学生被随机分组，研究保留率为99.3%。与维生素C相比，SP/AS和AQ/AS组的临床疟疾发病率分别降低了66.6%和46.5%（P < 0.001）。接受SP/AS或AQ/AS治疗的儿童因任何原因就诊的次数较少（P = 0.024）。在每次治疗后评估中，维生素C组的无症状寄生虫血症患病率是SP/AS或AQ/AS组的5倍（P < 0.001）。在传播期结束时，接受IPT治疗的儿童的贫血率较低（SP/AS，17.7%; AQ/AS，16.0%;维生素C，29.6%; P = 0.039）。
OBJECTIVE To assess the efficacy of intermittent preventive treatment (IPT) against malaria in school-aged children.METHODS This was an open randomized controlled trial of seasonal IPT among school children (IPTsc) aged 6-13 years in Kolle, Mali. The study began in September 2007 and completed follow-up in May 2008. Students were randomized to one of three study arms: Sulfadoxine-pyrimethamine plus artesunate (SP/AS), amodiaquine plus artesunate (AQ/AS) or vitamin C. All students received two full treatment doses, given 2 months apart during the season of high transmission from September to December. Groups were compared with respect to incidence of clinical malaria, asymptomatic parasitemia and haemoglobin concentration.RESULTS A total of 296 students were randomized, and retention in the study was 99.3%. Clinical malaria incidence in the SP/AS and AQ/AS arms was reduced by 66.6% and 46.5%, respectively, vs. vitamin C (P < 0.001). There were fewer clinic visits for any cause among the children receiving SP/AS or AQ/AS (P = 0.024). The prevalence of asymptomatic parasitemia was fivefold higher in the vitamin C arm than either SP/AS or AQ/AS at each post-treatment evaluation (P < 0.001). At the end of the transmission period, children treated with IPT had lower rates of anaemia (SP/AS, 17.7%; AQ/AS, 16.0%; vitamin C, 29.6%; P = 0.039).CONCLUSION IPT among school children reduced the rates of clinical malaria, all-cause acute clinic visits, asymptomatic parasitemia and anaemia among school-aged children.