TITLE

Intermittent Preventive Treatment for Malaria Control Administered at the Time of Routine Vaccinations in Mozambican Infants: A Randomized, Placebo-Controlled Trial

AUTHOR(S)
Macete, Eusebio; Aide, Pedro; Aponte, John J.; Sanz, Sergi; Mandomando, Inacio; Espasa, Mateu; Sigauque, Betuel; Dobaño, Carlota; Mabunda, Samuel; DgeDge, Martinho; Alonso, Pedro; Menendez, Clara
PUB. DATE
August 2006
SOURCE
Journal of Infectious Diseases;8/1/2006, Vol. 194 Issue 3, p276
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background. There is an urgent need to deploy and develop new control tools that will reduce the intolerable burden of malaria. Intermittent preventive treatment in infants (IPTi) has the potential to become an effective tool for malaria control. Methods. We performed a randomized, double-blind, placebo-controlled trial of sulfadoxine-pyrimethamine (SP) treatment in 1503 Mozambican children. Doses of SP or placebo were given at 3, 4, and 9 months of age. The intervention was administered alongside routine vaccinations delivered through the Expanded Program on Immunization (EPI). Hematological and biochemical tests were done when infants were 5 months old. Morbidity monitoring through a hospital-based passive case-detection system was complemented by cross-sectional surveys when infants were 12 and 24 months old. Results. IPTi was well tolerated, and no adverse events associated with SP were documented. During the first year of life, intermittent SP treatment reduced the incidence of clinical malaria by 22.2% (95% confidence interval [CI], 3.7%–37.0%; P = .020) and the rate of hospital admissions by 19% (95% CI, 4.0%–31.0%; P = .014). Although the incidence of severe anemia (packed cell volume of <25%) did not differ significantly between the 2 groups (protective effect, 12.7% [95% CI, -17.3% to 35.1%];P = .36), there was a significant reduction in hospital admissions for anemia during the month after dosing for both the first and second dose. The serological responses to EPI vaccines were not modified by the intervention. Conclusions. IPTi with SP has been shown to moderately reduce the incidence of clinical malaria in Mozambican infants without evidence of rebound after stopping the intervention or of interactions with EPI vaccines. Its recommendation as a malaria control strategy in Mozambique needs to be balanced against the scarcity of affordable control tools and the burden of malaria in children.
ACCESSION #
21544274

 

Related Articles

  • Randomized Trial of 2-Dose versus Monthly Sulfadoxine-Pyrimethamine Intermittent Preventive Treatment for Malaria in HIV-Positive and HIV-Negative Pregnant Women in Malawi. Filler, Scott J.; Kazembe, Peter; Thigpen, Michael; Macheso, Alan; Parise, Monica E.; Newman, Robert D.; Steketee, Richard W.; Hamel, Mary // Journal of Infectious Diseases;8/1/2006, Vol. 194 Issue 3, p286 

    Background. Intermittent preventive treatment during pregnancy (IPTp) with sulfadoxine-pyrimethamine(SP) decreases placental malaria parasitemia and associated maternal anemia, premature delivery, and low birth weight. However, the optimal regimen in the setting of a high prevalence of human...

  • Global subsidy of ACTs saves lives, buys time.  // PharmacoEconomics & Outcomes News;5/6/2006, Issue 502, p3 

    The article discusses research being done on the importance of a global subsidy of artemisinin-based combination therapies (ACT) for the treatment of malaria. It references a study by R. Laxminarayan et al published in the March 2006 issue of "Health Affairs." The six levels of subsidy for ACT...

  • CHOOSING AN ANTIMALARIAL DRUG. Driver, Carolyn // Practice Nurse;2/13/2004, Vol. 27 Issue 3, p46 

    Deals with antimalarial drugs that are available for travelers that go to malarious regions. Factors that need to be considered in choosing the right drug; Summary of malaria treatments, side-effects and dosage recommendation; Risk assessment.

  • Structure-Based Approaches to the Development of Novel Anti-Malarials. Brady, R. Leo; Cameron, Angus // Current Drug Targets;Feb2004, Vol. 5 Issue 2, p137 

    Malaria remains a major disease of mankind, and resistance to existing therapeutics is rapidly emerging. Limited financial investment to develop new therapeutics requires the careful selection of well-defined targets from the causative parasite, Plasmodium falciparum. In these circumstances,...

  • Antimalarial treatment with artemisinin combination therapy in Africa. Malenga, Grace; Palmer, Ayo; Staedke, Sarah; Kazadi, Walter; Mutabingwa, Thonest; Ansah, Evelyn; Barnes, Karen I.; Whitty, Christopher J. M. // BMJ: British Medical Journal (International Edition);10/1/2005, Vol. 331 Issue 7519, p706 

    Presents an editorial regarding antimalarial treatment with artemisinin combination therapy in Africa. Increase of drug resistant malaria across Africa; Report that combination therapies are now seen to be the best solution for treating malaria; Effectiveness of artemisinin based drug...

  • Synthesis and Antimalarial Activity of 1,2,4,5-Tetraoxanes. Yuxiang Dong, J.D. // Mini Reviews in Medicinal Chemistry;Apr2002, Vol. 2 Issue 2, p113 

    Methods for formation of 1,2,4,5-tetraoxanes are summarized and antimalarial activities of 1,2,4,5-tetraoxanes are discussed.

  • Ensuring quality and access for malaria diagnosis: how can it be achieved? Bell, David; Wongsrichanalai, Chansuda; Barnwell, John W. // Nature Reviews Microbiology;Sep2006, Vol. 4 Issue 9, p682 

    The replacement of conventional antimalarial drugs with high-cost, artemisinin-based alternatives has created a gap in the successful management of malaria. This gap reflects an increased need for accurate disease diagnosis that cannot be met by traditional microscopy techniques. The recent...

  • Intermittent Preventive Treatment in Infants -- Adjusting Expectations and Seeing Opportunity. ter Kuile, Feiko O.; Steketee, Richard W. // Journal of Infectious Diseases;8/1/2006, Vol. 194 Issue 3, p269 

    The article discusses the enforcement of intermittent preventive treatment with the administration of antimalarial drugs during pregnancy in the health care industry. The approach could produce a substantial reduction in rates of maternal anemia, placental parasite infection and the attendant...

  • Protecting Pregnant Women from Malaria in Areas of High HIV Infection Prevalence. Meshnick, Steven R.; Mwapasa, Victor; Rogerson, Stephen J. // Journal of Infectious Diseases;8/1/2006, Vol. 194 Issue 3, p273 

    The article discusses the protection of pregnant women from malaria in areas of high HIV infection prevalence in Africa. There is a paucity of evidence on which to base policies to protect HIV-infected pregnant women from malaria and other opportunistic infections. The application of...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics