Research press release


Nature Communications

Infectious diseases: Raining on malaria’s parade

アフリカで季節性マラリアの罹患率が最も高い地域、つまり、予防薬投与プログラムの恩恵を最も多く得られる可能性のある地域が特定された。これらの地域では推定小児人口が多いことから、現在マラリア防除が十分に達成されていない諸国で、この予防プログラムを実施すれば、多数のマラリアの症状発現を回避し、数千人の死者を減らすことができる可能性が明らかになった。この研究結果を報告する論文が、今週、Nature Communicationsに掲載される。

小児における季節性マラリアの化学的予防(SMC)は、マラリアの伝播に強い季節性が見られる地域での有望なマラリア防除方法とされる。しかし、薬剤によるマラリア予防法は、現在のところ、広範囲に実施されていない。今回、M Cairnsたちは、アフリカの56地域におけるマラリアの発生件数を12か月間連続して測定した。その結果、降水量に基づく十分な季節性が認められ、SMCによる予防効果を高い費用効果で得られる程度にマラリア発生件数の多い可能性の高い2つの広い地域が特定された。この2地域では、多くの5歳未満の小児がマラリア発症の危険にさらされているとCairnsたちは推定している。


The regions in Africa that are most susceptible to seasonal malaria and may therefore benefit most from preventative drug programmes are mapped in a paper in Nature Communications this week. Because large numbers of children are estimated to reside in this area, the authors suggest that deploying this method could avert a large number of malaria episodes and many thousands of deaths in several countries where malaria is currently not adequately controlled.

Seasonal malaria chemoprevention (SMC) in children is a promising tool for the control of malaria in areas where transmission of malaria is highly seasonal, however this drug-based method for malaria prevention is not currently employed widely. Matthew Cairns and colleagues looked at 56 sites over Africa where monthly malaria incidence was measured over 12 consecutive months. From this they highlight two large areas of Africa that are likely to have both sufficient seasonality, based on rainfall levels, and sufficient malaria incidence for SMC to be both effective and cost-effective. They estimate that a large population of children under 5 is at risk of malaria in these areas.

The authors mapped the potential impact of SMC administration over 4 months, however they note that some regions they identify as being optimal for treatment have two peaks during the year where climate relates to malarial incidence. They caution that their approach to SMC administration over 4 months of the year does not account for this scenario and further tweaking will be needed in these instances. Despite this, they conclude that a simple algorithm based on their findings could be developed to help policy makers decide whether the malaria incidence in their country, or certain regions within their country, is sufficiently seasonal for the deployment of SMC. They suggest that the algorithm could also indicate the potential impact of the implementation of SMC with different levels of efficacy and coverage.

doi: 10.1038/ncomms1879

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