Long-Term Impact of Malaria Chemoprophylaxis on Cognitive Abilities and Educational Attainment: Follow-Up of a Controlled Trial
Identifieur interne : 006D77 ( Main/Exploration ); précédent : 006D76; suivant : 006D78Long-Term Impact of Malaria Chemoprophylaxis on Cognitive Abilities and Educational Attainment: Follow-Up of a Controlled Trial
Auteurs : Matthew C. H. Jukes [Royaume-Uni] ; Margaret Pinder [Gambie] ; Elena L. Grigorenko [États-Unis] ; Helen Ba Os Smith [Royaume-Uni] ; Gijs Walraven [Gambie] ; Elisa Meier Bariau [États-Unis] ; Robert J. Sternberg [États-Unis] ; Lesley J. Drake [Royaume-Uni] ; Paul Milligan [Royaume-Uni] ; Yin Bun Cheung [Royaume-Uni] ; Brian M. Greenwood [Royaume-Uni] ; Donald A. P. Bundy [États-Unis]Source :
- PLoS Clinical Trials [ 1555-5887 ] ; 2006.
Abstract
We investigated the long-term impact of early childhood malaria prophylaxis on cognitive and educational outcomes.
This was a household-based cluster-controlled intervention trial.
The study was conducted in 15 villages situated between 32 km to the east and 22 km to the west of the town of Farafenni, the Gambia, on the north bank of the River Gambia.
A total of 1,190 children aged 3–59 mo took part in the trial. We traced 579 trial participants (291 in the prophylaxis group and 288 in the placebo group) in 2001, when their median age was 17 y 1 mo (range 14 y 9 mo to 19 y 6 mo).
Participants received malaria chemoprophylaxis (dapsone/pyrimethamine) or placebo for between one and three malaria transmission seasons from 1985 to 1987 during the controlled trial. At the end of the trial, prophylaxis was provided for all children under 5 y of age living in the study villages.
The outcome measures were cognitive abilities, school enrolment, and educational attainment (highest grade reached at school).
There was no significant overall intervention effect on cognitive abilities, but there was a significant interaction between intervention group and the duration of post-trial prophylaxis (
The results are suggestive of a long-term effect of malaria prophylaxis on cognitive function and educational attainment, but confirmatory studies are needed.
Url:
DOI: 10.1371/journal.pctr.0010019
PubMed: 17013430
PubMed Central: 1851720
Affiliations:
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H" last="Jukes">Matthew C. H. Jukes</name><affiliation wicri:level="3"><nlm:aff id="aff1">Partnership for Child Development, Department for Infectious Disease Epidemiology, Imperial College School of Medicine, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Partnership for Child Development, Department for Infectious Disease Epidemiology, Imperial College School of Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Pinder, Margaret" sort="Pinder, Margaret" uniqKey="Pinder M" first="Margaret" last="Pinder">Margaret Pinder</name><affiliation wicri:level="1"><nlm:aff id="aff2">Medical Research Council Laboratories, Banjul, Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Medical Research Council Laboratories, Banjul</wicri:regionArea><wicri:noRegion>Banjul</wicri:noRegion></affiliation></author><author><name sortKey="Grigorenko, Elena L" sort="Grigorenko, Elena L" uniqKey="Grigorenko E" first="Elena L" last="Grigorenko">Elena L. Grigorenko</name><affiliation wicri:level="2"><nlm:aff id="aff3">Center for the Psychology of Abilities, Competencies, and Expertise, Yale University, New Haven, Connecticut, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for the Psychology of Abilities, Competencies, and Expertise, Yale University, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="aff4">Child Study Center, Yale University, New Haven, Connecticut, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Child Study Center, Yale University, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Smith, Helen Ba Os" sort="Smith, Helen Ba Os" uniqKey="Smith H" first="Helen Ba Os" last="Smith">Helen Ba Os Smith</name><affiliation wicri:level="3"><nlm:aff id="aff1">Partnership for Child Development, Department for Infectious Disease Epidemiology, Imperial College School of Medicine, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Partnership for Child Development, Department for Infectious Disease Epidemiology, Imperial College School of Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Walraven, Gijs" sort="Walraven, Gijs" uniqKey="Walraven G" first="Gijs" last="Walraven">Gijs Walraven</name><affiliation wicri:level="1"><nlm:aff id="aff2">Medical Research Council Laboratories, Banjul, Gambia</nlm:aff><country xml:lang="fr">Gambie</country><wicri:regionArea>Medical Research Council Laboratories, Banjul</wicri:regionArea><wicri:noRegion>Banjul</wicri:noRegion></affiliation></author><author><name sortKey="Bariau, Elisa Meier" sort="Bariau, Elisa Meier" uniqKey="Bariau E" first="Elisa Meier" last="Bariau">Elisa Meier Bariau</name><affiliation wicri:level="2"><nlm:aff id="aff3">Center for the Psychology of Abilities, Competencies, and Expertise, Yale University, New Haven, Connecticut, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for the Psychology of Abilities, Competencies, and Expertise, Yale University, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Sternberg, Robert J" sort="Sternberg, Robert J" uniqKey="Sternberg R" first="Robert J" last="Sternberg">Robert J. Sternberg</name><affiliation wicri:level="2"><nlm:aff id="aff3">Center for the Psychology of Abilities, Competencies, and Expertise, Yale University, New Haven, Connecticut, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for the Psychology of Abilities, Competencies, and Expertise, Yale University, New Haven, Connecticut</wicri:regionArea><placeName><region type="state">Connecticut</region></placeName></affiliation></author><author><name sortKey="Drake, Lesley J" sort="Drake, Lesley J" uniqKey="Drake L" first="Lesley J" last="Drake">Lesley J. Drake</name><affiliation wicri:level="3"><nlm:aff id="aff1">Partnership for Child Development, Department for Infectious Disease Epidemiology, Imperial College School of Medicine, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Partnership for Child Development, Department for Infectious Disease Epidemiology, Imperial College School of Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Milligan, Paul" sort="Milligan, Paul" uniqKey="Milligan P" first="Paul" last="Milligan">Paul Milligan</name><affiliation wicri:level="3"><nlm:aff id="aff5">London School of Hygiene and Tropical Medicine, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Cheung, Yin Bun" sort="Cheung, Yin Bun" uniqKey="Cheung Y" first="Yin Bun" last="Cheung">Yin Bun Cheung</name><affiliation wicri:level="3"><nlm:aff id="aff5">London School of Hygiene and Tropical Medicine, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Greenwood, Brian M" sort="Greenwood, Brian M" uniqKey="Greenwood B" first="Brian M" last="Greenwood">Brian M. Greenwood</name><affiliation wicri:level="3"><nlm:aff id="aff5">London School of Hygiene and Tropical Medicine, London, United Kingdom</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>London School of Hygiene and Tropical Medicine, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Bundy, Donald A P" sort="Bundy, Donald A P" uniqKey="Bundy D" first="Donald A. P" last="Bundy">Donald A. P. Bundy</name><affiliation wicri:level="1"><nlm:aff id="aff6">Human Development Network, World Bank, Washington, District of Columbia, United States of America</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Human Development Network, World Bank, Washington, District of Columbia</wicri:regionArea><wicri:noRegion>District of Columbia</wicri:noRegion></affiliation></author></analytic><series><title level="j">PLoS Clinical Trials</title><idno type="eISSN">1555-5887</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="st1"><title>Objectives:</title><p>We investigated the long-term impact of early childhood malaria prophylaxis on cognitive and educational outcomes.</p></sec><sec id="st2"><title>Design:</title><p>This was a household-based cluster-controlled intervention trial.</p></sec><sec id="st3"><title>Setting:</title><p>The study was conducted in 15 villages situated between 32 km to the east and 22 km to the west of the town of Farafenni, the Gambia, on the north bank of the River Gambia.</p></sec><sec id="st4"><title>Participants:</title><p>A total of 1,190 children aged 3–59 mo took part in the trial. We traced 579 trial participants (291 in the prophylaxis group and 288 in the placebo group) in 2001, when their median age was 17 y 1 mo (range 14 y 9 mo to 19 y 6 mo).</p></sec><sec id="st5"><title>Interventions:</title><p>Participants received malaria chemoprophylaxis (dapsone/pyrimethamine) or placebo for between one and three malaria transmission seasons from 1985 to 1987 during the controlled trial. At the end of the trial, prophylaxis was provided for all children under 5 y of age living in the study villages.</p></sec><sec id="st6"><title>Outcome Measures:</title><p>The outcome measures were cognitive abilities, school enrolment, and educational attainment (highest grade reached at school).</p></sec><sec id="st7"><title>Results:</title><p>There was no significant overall intervention effect on cognitive abilities, but there was a significant interaction between intervention group and the duration of post-trial prophylaxis (<italic>p</italic> = 0.034), with cognitive ability somewhat higher in the intervention group among children who received no post-trial prophylaxis (treatment effect = 0.2 standard deviations [SD], 95% confidence interval [CI] −0.03 to 0.5) and among children who received less than 1 y of post-trial prophylaxis (treatment effect = 0.4 SD, 95% CI 0.1 to 0.8). The intervention group had higher educational attainment by 0.52 grades (95% CI = −0.041 to 1.089; <italic>p =</italic> 0.069). School enrolment was similar in the two groups.</p></sec><sec id="st8"><title>Conclusions:</title><p>The results are suggestive of a long-term effect of malaria prophylaxis on cognitive function and educational attainment, but confirmatory studies are needed.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Breman, Jg" uniqKey="Breman J">JG Breman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Snow, Rw" uniqKey="Snow R">RW Snow</name></author><author><name sortKey="Craig, M" uniqKey="Craig M">M Craig</name></author><author><name sortKey="Deichmann, U" uniqKey="Deichmann U">U Deichmann</name></author><author><name sortKey="Marsh, K" uniqKey="Marsh K">K Marsh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sachs, J" uniqKey="Sachs J">J Sachs</name></author><author><name sortKey="Malaney, P" uniqKey="Malaney P">P 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name="Royaume-Uni"><region name="Angleterre"><name sortKey="Jukes, Matthew C H" sort="Jukes, Matthew C H" uniqKey="Jukes M" first="Matthew C. H" last="Jukes">Matthew C. H. Jukes</name></region><name sortKey="Cheung, Yin Bun" sort="Cheung, Yin Bun" uniqKey="Cheung Y" first="Yin Bun" last="Cheung">Yin Bun Cheung</name><name sortKey="Drake, Lesley J" sort="Drake, Lesley J" uniqKey="Drake L" first="Lesley J" last="Drake">Lesley J. Drake</name><name sortKey="Greenwood, Brian M" sort="Greenwood, Brian M" uniqKey="Greenwood B" first="Brian M" last="Greenwood">Brian M. Greenwood</name><name sortKey="Milligan, Paul" sort="Milligan, Paul" uniqKey="Milligan P" first="Paul" last="Milligan">Paul Milligan</name><name sortKey="Smith, Helen Ba Os" sort="Smith, Helen Ba Os" uniqKey="Smith H" first="Helen Ba Os" last="Smith">Helen Ba Os Smith</name></country><country name="Gambie"><noRegion><name sortKey="Pinder, Margaret" sort="Pinder, Margaret" uniqKey="Pinder M" first="Margaret" last="Pinder">Margaret Pinder</name></noRegion><name sortKey="Walraven, Gijs" sort="Walraven, Gijs" uniqKey="Walraven G" first="Gijs" last="Walraven">Gijs Walraven</name></country><country name="États-Unis"><region name="Connecticut"><name sortKey="Grigorenko, Elena L" sort="Grigorenko, Elena L" uniqKey="Grigorenko E" first="Elena L" last="Grigorenko">Elena L. Grigorenko</name></region><name sortKey="Bariau, Elisa Meier" sort="Bariau, Elisa Meier" uniqKey="Bariau E" first="Elisa Meier" last="Bariau">Elisa Meier Bariau</name><name sortKey="Bundy, Donald A P" sort="Bundy, Donald A P" uniqKey="Bundy D" first="Donald A. P" last="Bundy">Donald A. P. Bundy</name><name sortKey="Grigorenko, Elena L" sort="Grigorenko, Elena L" uniqKey="Grigorenko E" first="Elena L" last="Grigorenko">Elena L. Grigorenko</name><name sortKey="Sternberg, Robert J" sort="Sternberg, Robert J" uniqKey="Sternberg R" first="Robert J" last="Sternberg">Robert J. Sternberg</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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