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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
A trial of the efficacy, safety and impact on drug resistance of four drug regimens for seasonal intermittent preventive treatment for malaria in Senegalese children
PLoS ONE, Volume 3, No. 1, Article e1471, Year 2008
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Description
In the Sahel, most malaria deaths occur among children 1-4 years old during a short transmission season. A trial of seasonal intermittent preventive treatment (IPT) with sulfadoxine-pyrimethamine (SP) and a single dose of artesunate (AS) showed an 86% reduction in the incidence of malaria in Senegal but this may not be the optimum regimen, We compaired this regimen with three alternatives. Methods. 2102 children aged 6-59 months received either one dose of SP plus one dose of AS (SP±1AS) (the previous regimen), one dose of SP plus 3 daily doses of AS (SP+3AS), one dose of SP plus three daily doses of amodiaquine (AQ) (SP+3AQ) or 3 daily doses of AQ and AS (3AQ+3AS). Treatments were given once a month on three occasions during the malaria transmission season. The primary end point was incidence of clinical malaria. Secondary end-points were incidence of adverse events, mean haemoglobin concentration and prevalence of parasites carrying markers of resistance to SP. Findings. The incidence of malaria, and the prevalence of parasitaemia at the end of the transmission season, were lowest in the group that received SP+3AQ 10% of children in the group that received SP+IAS had malaria, compared to 9% in the SP+3AS group (hazard ratio HR 0.90, 95%Cl 0.60, 1.36), 11% in the 3AQ+3AS group, HR 1.1 (0,76-1.7), and 5% in the SP+3AQ group, HR 0.50 (0.30-0.81). Mutations associated with resistance to SP were present in almost all parasites detected at the end of the transmission season, but the prevalence of Plasmodium falciparum was very low in the SP+3AQ group. Conclusions. Monthly treatment with SN+3AQ is a highly effective regimen for seasonal IPT. Choice of this regimen would minimise the spread of drug resistance and allow, artemisinins to be reserved for the treatment of acute clinical malaria. © 2008 Sokhna et al.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC2198946/bin/pone.0001471.s001.doc
https://efashare.b-cdn.net/share/pmc/articles/PMC2198946/bin/pone.0001471.s002.doc
Authors & Co-Authors
Sokhna, Cheikh Sadibou
Unknown Affiliation
Cissé, Badara
Unknown Affiliation
Bâ, Elhadji Hadj
Unknown Affiliation
Milligan, Paul J.M.
Unknown Affiliation
Hallett, Rachel L.
Unknown Affiliation
Sutherland, Colin J.
Unknown Affiliation
Gaye, Oumar H.
Unknown Affiliation
Boulanger, Denis
Unknown Affiliation
Simondon, Kirsten Bork
Unknown Affiliation
Simondon, François
Unknown Affiliation
Targett, Geoffrey A.T.
Unknown Affiliation
Lines, Jo D.
Unknown Affiliation
Greenwood, Brian M.
Unknown Affiliation
Trape, Jean François
Unknown Affiliation
Statistics
Citations: 93
Authors: 14
Affiliations: 4
Identifiers
Doi:
10.1371/journal.pone.0001471
e-ISSN:
19326203
Research Areas
Environmental
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Cohort Study
Study Locations
Senegal