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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Intermittent preventive treatment in infants as a means of malaria control: a randomized, double-blind, placebo-controlled trial in northern Ghana
Antimicrobial Agents and Chemotherapy, Volume 51, No. 9, Year 2007
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Description
Morbidity and mortality from malaria remain unacceptably high among young children in sub-Saharan Africa. Intermittent preventive treatment in infancy (IPTi) involves the administration of antimalarials alongside routine vaccinations and might be an option in malaria control. In an area of intense, perennial malaria transmission in northern Ghana, 1,200 children received IPTi with sulfadoxine-pyrimethamine or placebo at approximately 3,9, and 15 months of age. Children were followed up until 24 months of age to assess morbidity and adverse events. During the intervention period (3 to 18 months of age), IPTi reduced the incidences of malaria and severe anemia by 22.5% (95% confidence interval, 12 to 32%) and 23.6% (95% confidence interval, 4 to 39%), respectively, and reduced hospitalizations and episodes of asymptomatic parasitemia by one-third. Protection was pronounced in the first year of life and not discernible in the second. The malaria-protective effect was largely confined to a period of 1 month after sulfadoxine-pyrimethamine treatments. Following the intervention, protection against asymptomatic parasitemia persisted. In contrast, a significant rebound of severe malaria, predominantly severe malarial anemia, occurred among children having received IPTi. Although the treatment was generally well tolerated, one case of moderately severe skin reaction followed sulfadoxine-pyrimethamine treatment. IPTi reduces malaria and anemia in infants in northern Ghana. Extension of IPTi into the second year of life by administering a dose at 15 months of age provided no substantial benefit beyond a 1-month prophylactic effect. Although this simple intervention offers one of the few available malaria-preventive measures for regions where malaria is endemic, the observed rebound of severe malaria advises caution and requires further investigation. Copyright © 2007, American Society for Microbiology. All Rights Reserved.
Authors & Co-Authors
Mockenhaupt, Frank Peter
Germany, Berlin
Charité – Universitätsmedizin Berlin
Germany, Berlin
Institute of Tropical Medicine
Reither, Klaus
Germany, Berlin
Charité – Universitätsmedizin Berlin
Zanger, Philipp
Germany, Berlin
Charité – Universitätsmedizin Berlin
Roepcke, Felix
Germany, Berlin
Charité – Universitätsmedizin Berlin
Danquah, Ina
Germany, Berlin
Charité – Universitätsmedizin Berlin
Saad, Eiman
Germany, Berlin
Charité – Universitätsmedizin Berlin
Ziniel, Peter
Ghana
Northern Region Malaria Project Normap
Dzisi, Stephen Y.
Ghana
Northern Region Malaria Project Normap
Frempong, Marc
Ghana
Northern Region Malaria Project Normap
Agana-Nsiire, Patrick
Ghana, Cape Coast
Regional Health Administration Cape Coast
Amoo-Sakyi, Felicia
Ghana
Northern Region Malaria Project Normap
Otchwemah, Rowland N.
Ghana, Tamale
University for Development Studies Ghana
Cramer, Jakob Peter
Germany, Berlin
Charité – Universitätsmedizin Berlin
Anemana, Sylvester D.
Ghana, Cape Coast
Regional Health Administration Cape Coast
Dietz, Ekkehart
Germany, Berlin
Charité – Universitätsmedizin Berlin
Bienzle, Ulrich
Germany, Berlin
Charité – Universitätsmedizin Berlin
Statistics
Citations: 74
Authors: 16
Affiliations: 5
Identifiers
Doi:
10.1128/AAC.00513-07
ISSN:
00664804
Research Areas
Disability
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Study Locations
Ghana