在布基纳法索大规模分发阿兹罗米辛以预防儿童死亡率:CHAT随机临床试验
Catherine E Oldenburg1,2,3,4, Mamadou Ouattara5, Mamadou Bountogo5
1Francis I. Proctor Foundation, University of California, San Francisco.
JAMA
|February 13, 2024
概括
布基纳法索每年两次的大规模阿齐思罗米辛分发,与季节性疟疾化学预防相结合,显示了儿童死亡率下降的趋势,尽管结果在统计学上并不显著. 需要进一步的研究来证实它的有效性.
科学领域:
- 全球健康
- 传染性疾病
- 儿童医学
背景情况:
- 在撒哈拉以南的非洲地区, 大规模的阿齐思罗迈分发减少了儿童死亡率.
- 然而,它的有效性可能因地理位置和条件而异.
- 季节性疟疾化学预防 (SMC) 是儿童死亡率的一个关键干预措施.
研究的目的:
- 评估每年两次使用阿齐思罗米辛降低儿童死亡率的有效性.
- 在已有季节性疟疾化学预防的地区评估这一干预措施.
主要方法:
- 在布基纳法索进行了一项随机对照集群试验.
- 年龄在1-59个月的儿童每年两次接受阿兹胺或安慰剂治疗,持续3年.
- 所有原因的儿童死亡率是主要结果,通过人口普查进行测量.
主要成果:
- 亚齐胺的分布导致儿童死亡率没有显著降低 (IRR 0. 82;P=. 07).
- 这种效应在年长的儿童 (24-59个月) 中更为明显.
- 高依从率 (大约 在这两组中均有90%) 的患者.
结论:
- 两年间与SMC一起进行大规模的阿兹罗米辛分配可能会降低儿童死亡率,但这种差异在统计学上并不显著.
- 这项研究可能不足以发现显著的临床差异.
- 这些发现表明,特别是对于年长的儿童来说,有潜在的益处,需要进一步研究.
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