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Badara Cisse Matthew Cairns Ernest Faye Ousmane NDiaye Babacar Faye Cecile Cames Yue Cheng Maguette NDiaye Aminata Collé L? Kirsten Simondon Jean-Francois Trape Oumar Faye Jean Louis NDiaye Oumar Gaye Brian Greenwood Paul Milligan 《PloS one》2009,4(9)
Background
The long terminal half life of piperaquine makes it suitable for intermittent preventive treatment for malaria but no studies of its use for prevention have been done in Africa. We did a cluster randomized trial to determine whether piperaquine in combination with either dihydroartemisin (DHA) or sulfadoxine-pyrimethamine (SP) is as effective, and better tolerated, than SP plus amodiaquine (AQ), when used for intermittent preventive treatment in children delivered by community health workers in a rural area of Senegal.Methods
Treatments were delivered to children 3–59 months of age in their homes once per month during the transmission season by community health workers. 33 health workers, each covering about 60 children, were randomized to deliver either SP+AQ, DHA+PQ or SP+PQ. Primary endpoints were the incidence of attacks of clinical malaria, and the incidence of adverse events.Results
1893 children were enrolled. Coverage of monthly rounds and compliance with daily doses was similar in all groups; 90% of children received at least 2 monthly doses. Piperaquine combinations were better tolerated than SP+AQ with a significantly lower risk of common, mild adverse events. 103 episodes of clinical malaria were recorded during the course of the trial. 68 children had malaria with parasitaemia >3000/µL, 29/671 (4.3%) in the SP+AQ group, compared with 22/604 (3.6%) in the DHA+PQ group (risk difference 0.47%, 95%CI −2.3%,+3.3%), and 17/618 (2.8%) in the SP+PQ group (risk difference 1.2%, 95%CI −1.3%,+3.6%). Prevalences of parasitaemia and the proportion of children carrying Pfdhfr and Pfdhps mutations associated with resistance to SP were very low in all groups at the end of the transmission season.Conclusions
Seasonal IPT with SP+PQ in children is highly effective and well tolerated; the combination of two long-acting drugs is likely to impede the emergence of resistant parasites.Trial Registration
ClinicalTrials.gov NCT00529620相似文献2.
Tandakha N. Dieye Birahim P. NDiaye Alle B. Dieng Marema Fall Nathaniel Britain Samantha Vermaak Makhtar Camara Halimatou Diop-Ndiaye Ndeye Fatou Ngom-Gueye Papa A. Diaw Coumba Toure-Kane Papa S. Sow Souleymane Mboup Helen McShane 《PloS one》2013,8(6)
Tuberculosis (TB) is a global public health problem exacerbated by the HIV epidemic. Here we evaluate a candidate TB vaccine, MVA85A, in a Phase I study in HIV-infected adults in Senegal. 24 patients were enrolled: Group 1∶12, antiretroviral therapy (ART) naïve, adults, with CD4 counts >300 and HIV RNA load <100 000 copies/ml. Group 2∶12 adults, stable on ART, with CD4 counts >300, and an undetectable HIV RNA load. Safety was evaluated by occurrence of local and systemic adverse events (AEs) and by monitoring of CD4 count, HIV RNA load, haematology and biochemistry. Immunogenicity was evaluated by ex-vivo interferon-gamma ELISpot assay. 87.7% of AEs were mild; 11.6% were moderate; and 0.7% were severe. 29.2% of AEs were systemic; 70.8% were expected local AEs. There were no vaccine-related Serious Adverse Events (SAEs) or clinically significant effects on HIV RNA load or CD4 count. In ART naive subjects, the first MVA85A immunisation induced a significant immune response at 1 and 4 weeks post-immunisation, which contracted to baseline by 12 weeks. Durability of immunogenicity in subjects on ART persisted out to 24 weeks post-vaccination. A second dose of MVA85A at 12 months enhanced immunogenicity in ART naïve subjects. Subjects on ART had higher responses after the first vaccination compared with ART naïve subjects; responses were comparable after 2 immunisations. In conclusion, MVA85A is well-tolerated and immunogenic in HIV-infected subjects in Senegal. A two dose regimen in ART naïve subjects is comparable in immunogenicity to a single dose in subjects on ART.Clinicaltrials.gov trial identifier . NCT00731471相似文献
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Roeland Kindt Antoine Kalinganire Mahamane Larwanou Mamounata Belem Joseph Marie Dakouo Jules Bayala Maguette Kairé 《Biodiversity and Conservation》2008,17(8):1883-1905
Although farmers have managed west African parkland savanna systems for 1,000 of years, concerns have been raised about the
sustainability of these agro-ecosystems due to human population growth, shortening of fallow periods, droughts, desertification
and new orientations towards cash generation away from subsistence farming. We conducted a tree diversity survey in 16 villages
from Burkina Faso, Mali, Niger and Senegal, recording total species composition for 300 quadrats (mainly 50 × 20 m2) that were randomly sampled from the main landuse categories of parklands of village fields (VF), bush fields (BF), sylvopastoral
zone (SP) and forest reserves (FR). About 110 tree species were encountered, including 100 indigenous species. The results
from balanced species accumulation curves (based on randomized subsampling of the same number of quadrats from each village)
showed that the accumulated number of species was smallest in VF, largest in FR and almost equal in BF and SP, whereas classical
(unbalanced) species accumulation curves yielded different results. Although there was a significant within-village reduction
in species richness with increasing diameter class [averaging 8.5–13.1 more species in the smallest (<5 cm) compared to the
largest diameter class (>80 cm)] for the different landuse categories, new species were also encountered in larger diameter
classes (2.7–7.2 species). The evidence for tree regeneration problems (including problems in FR) suggest that farmer-managed
tree regeneration should be further explored and that advances in domestication and marketing of indigenous tree species may
be crucial to tree conservation in parkland systems. 相似文献
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