School-Based Malaria Screening and Treatment Reduces Plasmodium falciparum Infection and Anemia Prevalence in Two Transmission Settings in Malawi

被引：3

作者：

Cohee, Lauren M. ^{[1
]}

Peterson, Ingrid ^{[1
]}

Buchwald, Andrea G. ^{[1
]}

Coalson, Jenna E. ^{[2
,7
]}

Valim, Clarissa ^{[3
]}

Chilombe, Moses ^{[4
]}

Ngwira, Andrew ^{[4
]}

Bauleni, Andy ^{[4
]}

Schaffer-DeRoo, Sarah ^{[5
,8
]}

Seydel, Karl B. ^{[6
]}

Wilson, Mark L. ^{[2
]}

Taylor, Terrie E. ^{[6
]}

Mathanga, Don P. ^{[4
]}

Laufer, Miriam K. ^{[1
]}

机构：

[1] Univ Maryland, Sch Med, Ctr Vaccine Dev & Global Hlth, 685 West Baltimore St,HSF-1 1480, Baltimore, MD 21201 USA

[2] Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA

[3] Boston Univ, Sch Publ Hlth, Dept Global Hlth, Boston, MA USA

[4] Univ Malawi, Malaria Alert Ctr, Coll Med, Blantyre, Malawi

[5] Univ Maryland, Sch Med, Baltimore, MD 21201 USA

[6] Michigan State Univ, Coll Osteopath Med, E Lansing, MI 48824 USA

[7] Carter Ctr, Atlanta, GA USA

[8] Childrens Natl Med Ctr, Washington, DC 20010 USA

来源：

JOURNAL OF INFECTIOUS DISEASES | 2022年 / 226卷 / 01期

基金：

美国国家卫生研究院;

关键词：

chemoprevention; anemia; schoolchildren; adolescent; intervention; INTERMITTENT PREVENTIVE TREATMENT; AGED CHILDREN; DOUBLE-BLIND; SCHOOLCHILDREN; IMPACT; EDUCATION; UGANDA; HEALTH; TRIAL;

D O I：

10.1093/infdis/jiac097

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background In areas highly endemic for malaria, Plasmodium falciparum infection prevalence peaks in school-age children, adversely affecting health and education. School-based intermittent preventive treatment reduces this burden but concerns about cost and widespread use of antimalarial drugs limit enthusiasm for this approach. School-based screening and treatment is an attractive alternative. In a prospective cohort study, we evaluated the impact of school-based screening and treatment on the prevalence of P. falciparum infection and anemia in 2 transmission settings. Methods We screened 704 students in 4 Malawian primary schools for P. falciparum infection using rapid diagnostic tests (RDTs), and treated students who tested positive with artemether-lumefantrine. We determined P. falciparum infection by microscopy and quantitative polymerase chain reaction (qPCR), and hemoglobin concentrations over 6 weeks in all students. Results Prevalence of infection by RDT screening was 37% (9%-64% among schools). An additional 9% of students had infections detected by qPCR. Following the intervention, significant reductions in infections were detected by microscopy (adjusted relative reduction [aRR], 48.8%; P < .0001) and qPCR (aRR, 24.5%; P < .0001), and in anemia prevalence (aRR, 30.8%; P = .003). Intervention impact was reduced by infections not detected by RDT and new infections following treatment. Conclusions School-based screening and treatment reduced P. falciparum infection and anemia. This approach could be enhanced by repeating screening, using more-sensitive screening tests, and providing longer-acting drugs. In this cohortstudy of primary school students in 2 malaria transmission settings, school-based screening and treatment was associated with decreased prevalence of Plasmodium falciparuminfection and anemia. Impact was reduced by infections not detected and new infections following treatment.

引用

页码：138 / 146

页数：9

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