[2种基于氯喹的药物策略(发热病例预防和治疗)对疟疾传播的影响]。

V Robert, J P Hervy, D Baudon, J Roux, F Legros, P Carnevale
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摘要

决定在布基纳法索西南部的12个村庄进行一项为期3年的研究,比较发热病例的化学预防和化学治疗作为潜在的疟疾控制策略。在第一年收集预处理数据。在随后的两年中,实施了一项方案(1)对5个村庄的所有14岁以下儿童每周给予预防(10毫克氯喹/公斤体重),以及(2)对其他7个村庄的所有发热病例给予单剂量治疗(10毫克氯喹/公斤体重)。由社区卫生工作者分发氯喹片。预防和治疗均可使儿童(2-9岁)配子体率分别降低63%和45%。由于蚊子寿命的自然变化和蚊子的迁移,对按蚊一年后孢子率的演变分析变得困难。孢子率的显著变化可以用蚊子寿命的自然变化来解释。但是来自稻田村庄的数据支持这样的证据,即感染病媒的寄生虫池的减少导致冈比亚按蚊孢子虫率的下降。因此,我们的结果反映了一种趋势,而不仅仅是严格减少疟疾传播。
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[The effect of 2 chloroquine-based drug strategies (prevention and therapy of febrile cases] on malaria transmission].

A 3 years study was decided in 12 villages of the South-West Burkina Faso to compare the chemoprophylaxis and the chemotherapy of febrile cases as potential malaria control strategies. During the first year pretreatment data were collected. During the two following years a programme carried out (I) prophylaxis (10 mg chloroquine/kg body weight) was given weekly to all children under 14 years old in 5 villages, and (II) therapy (10 mg chloroquine/kg body weight) was given in a single dose to all febrile cases in 7 other villages. Chloroquine tablets were distributed by health workers belonging to the community. Both prophylaxis and therapy reduced the gametocyte rate in children (2-9 years) respectively of 63% and 45%. The analysis of the evolution after the first year of the sporozoite rate of anopheline was made difficult by concomitant natural variations of mosquitoes longevity and by mosquitoes displacements. Significant variations of sporozoite rate can be explained by natural variations of mosquitoes longevity. But data from the rice field villages support evidence that reduction of the pool of parasite infective for vectors induced the decrease of Anopheles gambiae s. l. sporozoite rate. Therefore our results reflect a trend more than a strict reduction of malaria transmission.

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