Impact of single annual treatment and four-monthly treatment for hookworm and Ascaris lumbricoides,and factors associated with residual infection among Kenyan school children  

作　　者：Stella Kepha Charles S.Mwandawiro Roy M.Anderson Rachel L.Pullan Fred Nuwaha Jorge Cano Sammy M.Njenga Maurice R.Odiere Elizabeth Allen Simon J.Brooker Birgit Nikolay 

机构地区：[1]School of Public Health,Makerere University College of Health Sciences,Kampala,Uganda [2]Eastern and Southern Africa Centre of International Parasite Control,Kenya Medical Research Institute(KEMRI),Nairobi,Kenya [3]London Centre for Neglected Tropical Disease Research,Department of Infectious Disease Epidemiology,School of Public Health,Imperial College London,London,UK [4]London School of Hygiene and Tropical Medicine,London,UK [5]Centre for Global Health Research,KEMRI,Kisumu,Kenya [6]KEMRI-Wellcome Trust Research Programme,Nairobi,Kenya

出　　处：《Infectious Diseases of Poverty》2017年第1期249-260,共12页贫困所致传染病（英文）

基　　金：The trial was supported by the Dissecting the Immunological Interplay between Poverty Related Diseases and Helminth Infections:An African-European Research Initiative(IDEA)consortium,which is funded by the European Union through its FP7-HEALTH-2009 programme;SK is supported by a PhD training fellowship from THRiVE(Training Health Researchers into Vocational Excellence in East Africa)consortium;which is funded by the Wellcome Trust(087540);SJB is supported by a Wellcome Trust Senior Fellowship in Basic Biomedical Science(098045);which also supports RLP.

摘　　要：Background:School-based deworming is widely implemented in various countries to reduce the burden of soil-transmitted helminths(STHs),however,the frequency of drug administration varies in different settings.In this study,we compared the impact of a single annual treatment and 4-monthly treatment over a follow-up among Kenyan school children,and investigated the factors associated with residual infection.Methods:We performed a secondary analysis of data from a randomized trial investigating whether deworming for STHs alters risk of acquiring malaria.Children received either a single treatment or 4-monthly albendazole treatments were followed longitudinally from February 2014 to October 2014.The relative impact of treatment and factors associated with residual infections were investigated using mixed-effects regression models.Predisposition to infection was assessed based on Spearman’s rank and Kendall’s Tau correlation coefficients.Results:In the 4-monthly treatment group,the proportion of children infected with hookworm decreased from 59.9 to 5.7%,while Ascaris lumbricoides infections dropped from 55.7 to 6.2%.In the single treatment group,hookworm infections decreased over the same time period from 58.7 to 18.3%(12.6%absolute difference in reduction,95%CI:8.9-16.3%),and A.lumbricoides from 56.7 to 23.3%(17.1%absolute difference in reduction,95%CI:13.1-21.1%).There was strong evidence for predisposition to both STH types.Residual hookworm infection among children on 4-monthly treatment were associated with male sex and baseline nutritional status,whereas A.lumbricoides infection was associated with individual and school-level infection at baseline,latrine cleanliness at schools.Conclusions:This study found that 4-monthly treatment w more effective than single annual treatment.Repeated treatments led to dramatic reductions in the intensities of STHs,but did not completely clear infections among school children in Kenya,a presumed reflection of reinfection in a setting where there is ongoing transmission.

关 键 词：School-based deworming Soil-transmitted helminths ALBENDAZOLE School children Kenya 

分 类 号：R53[医药卫生—内科学]