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作 者:李国桥[1] 宋健平[1] 邓长生[1] Moussa Mohamed Ahamada MSA Mliva Fatihou Oithik 陈沛泉[1] 谈博[1]
机构地区:[1]广州中医药大学青蒿研究中心,广东广州510405 [2]科摩罗国家卫生部和疟疾控制中心
出 处:《广州中医药大学学报》2010年第1期90-98,共9页Journal of Guangzhou University of Traditional Chinese Medicine
摘 要:【目的】探讨在Moheli岛实施快速灭源灭疟法(FEMSE)治疗疟疾的效果。【方法】采用FEMSE法制定统一的疟疾治疗方案,对疟原虫诊断阳性者,按Artequick-Primaquine(青蒿素-哌喹-伯氨喹)标准方案(2d为1疗程)给予治疗:成人首剂2片,24h后再服2片,1疗程总量4片。儿童带虫率<10%的地区全民服药1次;儿童带虫率≥10%的村进行两次全民服药,相隔42 d。主要观察服药率及人群带虫率。【结果】服药率:第1次全民服药人数合计32 519人(同期登记总人口数为37243人,367个6个月以内的婴儿未参与服药),服药率为88.2%;第2次全民服药人数合计35 370人(同期登记总人口数为37 112人,335个6个月以内的婴儿未参与服药),服药率为96.2%。人群带虫率:全民服药前人群带虫率为22.95%(281/1 224),全民服药后2个月带虫率降为1.41%(28/1 987),4个月带虫率降为0.33%(8/2 458),下降幅度为98.56%。【结论】全民服药后4个月人群带虫率从22.95%下降到0.33%,表明采用FEMSE法服用Artequick-Primaquine清除体内疟原虫能够在短时间内使人群带虫率迅速下降,且未见明显的不良反应。在巩固阶段若能有效地组织监督实施清除疟疾的计划,可使人群带虫率和发病率进一步下降。Objective To investigate the therapeutic effect of the method of Fast Elimination of Malaria by Source Eradication (FEMSE) in Moheli island of Comoros. Methods Based on the FEMSE project, parasite positive cases were given a standard treatment course of ARTEQUICK (artemisinin plus piperaquine) plus primaquine: two tablets for adults at 0 hour and two tablets at 24 hours, a total of 4 tablets during one treatment course. One time of Mass Drug Administration (MDA) was for the children with parasite carrier rate less than 10%. Two times of MDA was for the children with parasite carrier rate more than 10%, and the interval between the two MDA was 42 days. Coverage rate for MDA and population carrier rate were observed. Results The number of people taking the first MDA of Artequick-Primaquine was 32,519 (the whole population registered at the same time being 37,243, 367 infants under 6 months old not involved), and the coverage rate for MDA was 88.2%. The population involved in the second MDA was 35,370 ( the whole population registered at the same time being 37,112, 335 infants under 6 months old not involved) , and the coverage rate for MDA was 96. 2%. Parasite carrier rate was 22.95% (281/ 1,224) before MDA, 1.41% (28/1, 987) two months after MDA and 0. 33% (8/2,458) four months after MDA, with a decrease of 98.56% . Conclusion The decrease of parasite carrier rate from 22.95% to 0. 33% before and after MDA indicates that MDA of Artequick-Primaquine based on FEMSE can decrease the parasite carrier rate in a short time, without any obvious side effects. Further decrease of parasite carrier rate and incidence will be achieved if the measures for clearing malaria are fully implementated during the consolidation phase.
关 键 词:青蒿素-哌喹-伯氨喹/治疗应用 疟疾/药物疗法 快速灭源灭疟
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