4). However, there was no marked difference in the reduction of asymptomatic carriers with anemia between each arm over this 12-month period. Outcomes in All Subjects (Community Level) There was no significant buy KU-60019 difference in the increase in Hb from Campaign 1 to 4 in subjects aged >6 months to <5 years between the two arms. The change in Hb level was +0.76 g/dl (from 10.24 to 10.99 g/dl) in the intervention arm vs. +1.08 g/dl (from 10.04 to 11.13 g/dl) in the control arm (P = 0.9318). The difference between the increase in Hb from Campaign 1 to 4 in subjects aged 5–9,
10–14, and ≥15 years in the two arms was not significant. Hb levels at Campaign 4 in these age groups were similar to Hb levels in populations without endemic malaria, and there was a trend of increasing Hb level with increasing age: children aged 5–9 years had a mean Hb of 11.97 vs. 12.13 g/dl (intervention vs. control
arms), and children aged 10–14 years had a mean Hb of 12.58 vs. 12.72 g/dl, while study participants aged ≥15 years had a mean Hb of 13.25 vs. 13.42 g/dl. Distribution of Hb Levels (All Subjects) Hb levels within both study arms were similarly distributed on Days 1 and 28 of Campaign 1, and on Day 1 of Campaign 4, with the majority of the Hb levels falling within the outer limits. There was little difference between the study arms in the distribution of Hb levels on Day 1 and Day 28 of Campaign 1 and on Day 1 of Campaign 4 (Fig. 5). Fig. 5 Distribution of hemoglobin (Hb) levels in all subjects on Day 1, Day 28, and at 12 months Discussion In this study, this website community screening and targeted
treatment of asymptomatic carriers of P. falciparum malaria had a significant impact on short-term (28 days) Hb levels Cytidine deaminase in these asymptomatic carriers, including significantly improving Hb levels in all asymptomatic carriers >6 months, and reducing the incidence of anemia in asymptomatic carriers aged >6 months to <5 years by over 30%. However, more research is needed to understand if this is a direct effect of AL therapy. While it is known that AL has a consistently high efficacy and safety in the treatment of P. falciparum malaria , some factors in this study, such as the concurrent treatment of all symptomatic cases in both arms, and the use of LLINs, may have contributed to the improved Hb levels. It should be noted that these short-term improvements in Hb levels did correlate with the reduction in carriage of asexual forms and gametocytes seen in these asymptomatic carriers after 28 days of AL therapy (there was a significant reduction in asymptomatic and gametocyte carriage from baseline to the assessment at the beginning of Campaigns 2 and 3) . Only 0.2% of patients in the intervention arm and none in control arm required hematinic treatment (for Hb <5 g/dl on Day 1 of Campaign 1), making it unlikely that this intervention influenced the overall Hb changes.