向药物管理以减少疟疾传播:系统性审查和元分析
Maria Tusell1, Elisabet Martí Coma-Cros1, Beena Bhamani1
1Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
The American journal of tropical medicine and hygiene
|January 24, 2024
概括
向低传播地区的高风险群体提供抗疟疾药物的向药物管理 (TDA) 减少了这些群体内的感染. 然而,这种策略并没有证明在人口层面上显著减少疟疾传播.
科学领域:
- 全球健康 全球健康
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 在疟疾传播低的环境中,特定的人群可能会承担不成比例的感染份额.
- 针对这些高风险群体的干预措施可能会减少疟疾的总体传播.
研究的目的:
- 系统地审查抗疟药物向药物管理 (TDA) 对高风险群体疟疾传播的影响.
主要方法:
- 进行了系统的文献搜索 (2021年3月,更新至2022年4月).
- 包括五项研究:两项集群随机对照试验,一项对照前后研究和两项不受控制的前后研究.
- 使用推评估,开发和评价 (GRADE) 方法来评估证据的确定性.
主要成果:
- 针对性药物管理 (TDA) 在人口水平感染流行率上几乎没有差异 (RR:0.85,95% CI:0.73-1.00;高确定性).
- TDA可能导致目标个体感染率大幅降低 (RR:0.15,95%CI:0.06-0.38;中等确定性).
结论:
- 虽然TDA可以减轻治疗个体的疟疾负担,但目前的证据不支持其在减少低传播地区的人口水平的疟疾传播方面的有效性.
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