Seasonal Intermittent Preventive Treatment for the Prevention of Anaemia and Malaria in Ghanaian Children A Randomized, Placebo Controlled Trial 英文参考文献.docVIP

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Seasonal Intermittent Preventive Treatment for the Prevention of Anaemia and Malaria in Ghanaian Children A Randomized, Placebo Controlled Trial 英文参考文献.doc

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Seasonal Intermittent Preventive Treatment for the Prevention of Anaemia and Malaria in Ghanaian Children A Randomized, Placebo Controlled Trial 英文参考文献

SeasonalIntermittentPreventiveTreatmentforthe PreventionofAnaemiaandMalariainGhanaian Children:ARandomized,PlaceboControlledTrial MargaretKweku1,2,DongmeiLiu1,MartinAdjuik3,FredBinka4,MahmoodSeidu2,5,BrianGreenwood1, DanielChandramohan1* 1London School of Hygiene and Tropical Medicine, London, United Kingdom, 2Ghana Health Service, University of Ghana, Legon, Accra, Ghana, 3Navrongo Health ResearchCentre,UniversityofGhana,Legon,Accra,Ghana,4SchoolofPublicHealth,UniversityofGhana,Legon,Accra,Ghana,5UniversityofGhanaMedicalSchool, Korle-bu,Accra,Ghana Abstract Background:Malariaandanaemiaaretheleadingcausesofmorbidityandmortalityinchildreninsub-SaharanAfrica.We have investigated the effect of intermittent preventive treatment with sulphadoxine-pyrimethamine or artesunate plus amodiaquineonanaemiaandmalariainchildreninanareaofintense,prolonged,seasonalmalariatransmissioninGhana. Methods:2451childrenaged3–59monthsfrom30villageswereindividuallyrandomisedtoreceiveplaceboorartesunate plusamodiaquine(AS+AQ)monthlyorbimonthly,orsulphadoxine-pyrimethamine(SP)bimonthlyoveraperiodofsixmonths. Theprimaryoutcomemeasureswereepisodesofanaemia(Hb,8.0g/dl)ormalariadetectedthroughpassivesurveillance. Findings:Monthlyartesunateplusamodiaquinereducedtheincidenceofmalariaby69%(95%CI:63%,74%)andanaemia by 45% (95% CI: 25%,60%), bimonthly sulphadoxine-pyrimethamine reduced the incidence of malaria by 24% (95% CI: 14%,33%)andanaemiaby30%(95%CI:6%,49%)andbimonthlyartesunateplusamodiaquinereducedtheincidenceof malariaby17%(95%CI:6%,27%)andanaemiaby32%(95%CI:7%,50%)comparedtoplacebo.Therewerenostatistically significantreductionsintheepisodesofallcauseormalariaspecifichospitaladmissionsinanyoftheinterventiongroups compared to the placebo group. There was no significant increase in the incidence of clinical malaria in the post interventionperiodinchildrenwhowere.1yearoldwhentheyreceivedIPTccomparedtotheplacebogroup.However theincidenceofmalariainthepostinterventionperiodwashigherinchildrenwhower