Malaria prevention reduces in-hospital mortality among severely ill tuberculosis patients: a three-step intervention in Bissau, Guinea-Bissau

BMC Infectious Diseases

Research Article

Raffaella Colombatti¹  Carlo Giaquinto²  Martina Penazzato²  Federica Bassani³  Cesaltina Silva Vieira³  Antonia Araujo Lourenço³  Fina Vieira³  Fabio Riccardi⁴  Simone Teso⁵ 

[1] Clinic of Pediatric Hematology-Oncology, Department of Pediatrics, University of Padova, Padova, Italy;National Reference Hospital for Tuberculosis and Lung Disease, Bissau, Guinea-Bissau;Infectious Disease Unit, Department of Pediatrics, University of Padova, Padova, Italy;National Reference Hospital for Tuberculosis and Lung Disease, Bissau, Guinea-Bissau;National Reference Hospital for Tuberculosis and Lung Disease, Bissau, Guinea-Bissau;Department of Public Health and Cell Biology "Tor Vergata" University, Rome, Italy;University of Padova, Padova, Italy;

关键词: Malaria;    Rainy Season;    Malaria Prevention;    Personal Protection;    Malaria Prophylaxis;   

DOI  :  10.1186/1471-2334-11-57

 received in 2010-08-31, accepted in 2011-03-02,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundMalaria and Tuberculosis (TB) are important causes of morbidity and mortality in Africa. Malaria prevention reduces mortality among HIV patients, pregnant women and children, but its role in TB patients is not clear. In the TB National Reference Center in Guinea-Bissau, admitted patients are in severe clinical conditions and mortality during the rainy season is high. We performed a three-step malaria prevention program to reduce mortality in TB patients during the rainy season.MethodsSince 2005 Permethrin treated bed nets were given to every patient. Since 2006 environmental prevention with permethrin derivates was performed both indoor and outdoor during the rainy season. In 2007 cotrimoxazole prophylaxis was added during the rainy season. Care was without charge; health education on malaria prevention was performed weekly. Primary outcomes were death, discharge, drop-out.Results427, 346, 549 patients were admitted in 2005, 2006, 2007, respectively. Mortality dropped from 26.46% in 2005 to 18.76% in 2007 (p-value 0.003), due to the significant reduction in rainy season mortality (death/discharge ratio: 0.79, 0.55 and 0.26 in 2005, 2006 and 2007 respectively; p-value 0.001) while dry season mortality remained constant (0.39, 0.37 and 0.32; p-value 0.647). Costs of malaria prevention were limited: 2€/person. No drop-outs were observed. Health education attendance was 96-99%.ConclusionsMalaria prevention in African tertiary care hospitals seems feasible with limited costs. Vector control, personal protection and cotrimoxazole prophylaxis seem to reduce mortality in severely ill TB patients. Prospective randomized trials are needed to confirm our findings in similar settings.Trial registration numberCurrent Controlled Trials: ISRCTN83944306

【 授权许可】

CC BY   
© Colombatti et al; licensee BioMed Central Ltd. 2011