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首页> 外文期刊>Transactions of the Royal Society of Tropical Medicine and Hygiene >Feasibility, safety and effectiveness of combining home based malaria management and seasonal malaria chemoprevention in children less than 10 years in Senegal: A cluster-randomised trial
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Feasibility, safety and effectiveness of combining home based malaria management and seasonal malaria chemoprevention in children less than 10 years in Senegal: A cluster-randomised trial

机译：塞内加尔10岁以下儿童在家中进行疟疾管理和季节性疟疾化学预防相结合的可行性，安全性和有效性：一项整群随机试验

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Background: Home-based management of malaria (HMM) may improve access to diagnostic testing and treatment with artemisinin combination therapy (ACT). In the Sahel region, seasonal malaria chemoprevention (SMC) is now recommended for the prevention of malaria in children. It is likely that combinations of antimalarial interventions can reduce the malaria burden. This study assessed the feasibility, effectiveness and safety of combining SMC and HMM delivered by community health workers (CHWs). Methods: A cluster-randomised trialwas carried out during two transmission seasons in eight villages located in the south-eastern part of Senegal. Intervention communities received HMM+SMC while control communities received HMM. Primary end point was the incidence of malaria attacks during the follow up period. Secondary end points included: malaria diagnostic accuracy; access to ACT treatment; SMC coverage; safety and drug tolerability. Results: The adjusted rate ratio for incidence of malaria attacks in intervention and control communities was 0.15, indicating a protective effect of HMM+SMC of 85% (95% CI: 39.9-96.3%, p=0.01). Access to ACT treatment was 96.4% while SMC coverage represented 97.3% (95% CI: 91.3-100%) in 2010, and 88.8% (95% CI: 84.2-93.6%) in 2011. No serious adverse events were recorded. Conclusion: It seems feasible and safe to combine SMC with HMM intervention, while achieving high coverage and effectiveness of both SMC and HMM. Trial registration: (www.pactr.org) PACTR201305000551876.
机译：背景：以家庭为基础的疟疾管理（HMM）可能会改善使用青蒿素联合疗法（ACT）进行诊断测试和治疗的机会。在萨赫勒地区，现在建议使用季节性疟疾化学预防（SMC）预防儿童疟疾。组合使用抗疟措施可以减轻疟疾负担。这项研究评估了社区卫生工作者（CHW）提供的SMC和HMM结合使用的可行性，有效性和安全性。方法：在塞内加尔东南部的八个村庄的两个传播季节进行了整群随机试验。干预社区接受了HMM + SMC，而对照社区接受了HMM。主要终点是随访期内疟疾发作的发生率。次要终点包括：疟疾诊断的准确性;获得ACT治疗; SMC覆盖范围;安全性和药物耐受性。结果：干预和对照社区的疟疾发作发生率调整后的比率为0.15，表明HMM + SMC的保护作用为85％（95％CI：39.9-96.3％，p = 0.01）。接受ACT治疗的比例为96.4％，而SMC覆盖率在2010年为97.3％（95％CI：91.3-100％），在2011年为88.8％（95％CI：84.2-93.6％）。未记录到严重的不良事件。结论：将SMC与HMM干预相结合似乎既可行又安全，同时实现SMC和HMM的高覆盖率和有效性。试用注册：（www.pactr.org）PACTR201305000551876。

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