Self-reported compliance with last malaria treatment and occurrence of malaria during follow-up in a Brazilian Amazon population
Self-reported compliance with last malaria treatment and occurrence of malaria during follow-up in a Brazilian Amazon population
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DOI：
10.1046/j.1365-3156.2003.01042.x
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发表时间：
2003-06-01
影响因子：
3.3
通讯作者：
Gyorkos, TW
中科院分区：
文献类型：
--
作者：
Duarte, EC;Gyorkos, TW
本研究的目的是描述自我报告的最后一次疟疾治疗（CMT）的依从性与随访期间疟疾的发生之间的关联，控制当前的风险因素。我们在巴西马托格罗索亚马逊地区Peixoto de Azevedo市的一个农村地区Leonislandia进行了一项前瞻性开放队列研究。共414人进行了采访，在基线有关CMT和随访8个月或4个月，以评估疟疾发病率。CMT和疟疾发生之间的关联通过多元线性回归（当结果是疟疾发作频率时）或考克斯回归（当结果是疟疾发作时间时）进行检查。CMT差（基线前）被确定为后续疟疾发作发生的一个重要预测因素，在随访过程中，有迹象表明免疫力较低的个体-那些首次疟疾发作相对较近或那些在过去2年中疟疾发作次数增加的个体。此外，令人惊讶的是，似乎对于那些可能更具免疫力的人（那些在4.5年前经历过首次疟疾发作的人或那些在过去2年中很少或没有疟疾发作的人），CMT被发现是后续疟疾风险增加的不良预测因素。这些发现为进一步研究CMT及其对疟疾结局的影响提供了令人信服的证据。
The objective of this study was to describe the association between self-reported compliance with last malaria treatment (CMT) and occurrence of malaria during follow-up, controlling for current risk factors. We conducted a prospective open cohort study in Leonislandia, a rural area of Peixoto de Azevedo City, in the Amazon region of Mato Grosso, Brazil. A total of 414 individuals were interviewed at baseline regarding CMT and followed-up for either 8 or 4 months to assess malaria incidence. The associations between CMT and occurrence of malaria were examined through multiple linear regression (when the outcome was malaria episode frequency) or Cox regression (when the outcome was time to malaria onset). Poor CMT (prior to baseline) was identified as an important predictor of the occurrence of subsequent malaria episodes during follow-up among individuals with an indication of being less immune - those whose first malaria episode was relatively recent or those who had an increased number of malaria episodes during the last 2 years. Moreover, surprisingly, it seems that for individuals who are probably more immune (individuals who had experienced their first malaria episode more than 4.5 years previously or those with few or no malaria episodes during the last 2 years), CMT was found to be a poor predictor of increased risk of subsequent malaria. These findings provide compelling evidence for the need to further study CMT and its effect on malaria outcomes.