Intermittent preventive treatment using artemisinin-based combination therapy reduces malaria morbidity among school-aged children in Mali

Breanna Barger, Hamma Maiga, Oumar Bila Traore, Mamadou Tekete, Intimbeye Tembine, Antoine Dara, Zoumana Isaac Traore, Soren Gantt, Ogobara K. Doumbo, Abdoulaye A. Djimde

Research output: Contribution to journalArticle

Abstract

Objective To assess the efficacy of intermittent preventive treatment (IPT) against malaria in school-aged children. Methods This was an open randomized controlled trial of seasonal IPT among school children (IPTsc) aged 6-13 years in Kollé, Mali. The study began in September 2007 and completed follow-up in May 2008. Students were randomized to one of three study arms: Sulfadoxine-pyrimethamine plus artesunate (SP/AS), amodiaquine plus artesunate (AQ/AS) or vitamin C. All students received two full treatment doses, given 2 months apart during the season of high transmission from September to December. Groups were compared with respect to incidence of clinical malaria, asymptomatic parasitemia and haemoglobin concentration. Results A total of 296 students were randomized, and retention in the study was 99.3%. Clinical malaria incidence in the SP/AS and AQ/AS arms was reduced by 66.6% and 46.5%, respectively, vs. vitamin C (P < 0.001). There were fewer clinic visits for any cause among the children receiving SP/AS or AQ/AS (P = 0.024). The prevalence of asymptomatic parasitemia was fivefold higher in the vitamin C arm than either SP/AS or AQ/AS at each post-treatment evaluation (P < 0.001). At the end of the transmission period, children treated with IPT had lower rates of anaemia (SP/AS, 17.7%; AQ/AS, 16.0%; vitamin C, 29.6%; P = 0.039). Conclusion IPT among school children reduced the rates of clinical malaria, all-cause acute clinic visits, asymptomatic parasitemia and anaemia among school-aged children.

Original languageEnglish (US)
Pages (from-to)784-791
Number of pages8
JournalTropical Medicine and International Health
Volume14
Issue number7
DOIs
StatePublished - Jul 2009
Externally publishedYes

Fingerprint

Mali
Malaria
Morbidity
Ascorbic Acid
Parasitemia
Ambulatory Care
Students
Anemia
Therapeutics
Incidence
artemisinine
Hemoglobins
Randomized Controlled Trials
artesunate drug combination amodiaquine
sulfadoxine-pyrimethamine-artesunate

Keywords

  • Artemisinin
  • Children
  • Intermittent preventive treatment
  • Malaria
  • School

ASJC Scopus subject areas

  • Parasitology
  • Medicine(all)
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Intermittent preventive treatment using artemisinin-based combination therapy reduces malaria morbidity among school-aged children in Mali. / Barger, Breanna; Maiga, Hamma; Traore, Oumar Bila; Tekete, Mamadou; Tembine, Intimbeye; Dara, Antoine; Traore, Zoumana Isaac; Gantt, Soren; Doumbo, Ogobara K.; Djimde, Abdoulaye A.

In: Tropical Medicine and International Health, Vol. 14, No. 7, 07.2009, p. 784-791.

Research output: Contribution to journalArticle

Barger, B, Maiga, H, Traore, OB, Tekete, M, Tembine, I, Dara, A, Traore, ZI, Gantt, S, Doumbo, OK & Djimde, AA 2009, 'Intermittent preventive treatment using artemisinin-based combination therapy reduces malaria morbidity among school-aged children in Mali', Tropical Medicine and International Health, vol. 14, no. 7, pp. 784-791. https://doi.org/10.1111/j.1365-3156.2009.02294.x
Barger, Breanna ; Maiga, Hamma ; Traore, Oumar Bila ; Tekete, Mamadou ; Tembine, Intimbeye ; Dara, Antoine ; Traore, Zoumana Isaac ; Gantt, Soren ; Doumbo, Ogobara K. ; Djimde, Abdoulaye A. / Intermittent preventive treatment using artemisinin-based combination therapy reduces malaria morbidity among school-aged children in Mali. In: Tropical Medicine and International Health. 2009 ; Vol. 14, No. 7. pp. 784-791.
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abstract = "Objective To assess the efficacy of intermittent preventive treatment (IPT) against malaria in school-aged children. Methods This was an open randomized controlled trial of seasonal IPT among school children (IPTsc) aged 6-13 years in Koll{\'e}, Mali. The study began in September 2007 and completed follow-up in May 2008. Students were randomized to one of three study arms: Sulfadoxine-pyrimethamine plus artesunate (SP/AS), amodiaquine plus artesunate (AQ/AS) or vitamin C. All students received two full treatment doses, given 2 months apart during the season of high transmission from September to December. Groups were compared with respect to incidence of clinical malaria, asymptomatic parasitemia and haemoglobin concentration. Results A total of 296 students were randomized, and retention in the study was 99.3{\%}. Clinical malaria incidence in the SP/AS and AQ/AS arms was reduced by 66.6{\%} and 46.5{\%}, respectively, vs. vitamin C (P < 0.001). There were fewer clinic visits for any cause among the children receiving SP/AS or AQ/AS (P = 0.024). The prevalence of asymptomatic parasitemia was fivefold higher in the vitamin C arm than either SP/AS or AQ/AS at each post-treatment evaluation (P < 0.001). At the end of the transmission period, children treated with IPT had lower rates of anaemia (SP/AS, 17.7{\%}; AQ/AS, 16.0{\%}; vitamin C, 29.6{\%}; P = 0.039). Conclusion IPT among school children reduced the rates of clinical malaria, all-cause acute clinic visits, asymptomatic parasitemia and anaemia among school-aged children.",
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AU - Traore, Oumar Bila

AU - Tekete, Mamadou

AU - Tembine, Intimbeye

AU - Dara, Antoine

AU - Traore, Zoumana Isaac

AU - Gantt, Soren

AU - Doumbo, Ogobara K.

AU - Djimde, Abdoulaye A.

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N2 - Objective To assess the efficacy of intermittent preventive treatment (IPT) against malaria in school-aged children. Methods This was an open randomized controlled trial of seasonal IPT among school children (IPTsc) aged 6-13 years in Kollé, Mali. The study began in September 2007 and completed follow-up in May 2008. Students were randomized to one of three study arms: Sulfadoxine-pyrimethamine plus artesunate (SP/AS), amodiaquine plus artesunate (AQ/AS) or vitamin C. All students received two full treatment doses, given 2 months apart during the season of high transmission from September to December. Groups were compared with respect to incidence of clinical malaria, asymptomatic parasitemia and haemoglobin concentration. Results A total of 296 students were randomized, and retention in the study was 99.3%. Clinical malaria incidence in the SP/AS and AQ/AS arms was reduced by 66.6% and 46.5%, respectively, vs. vitamin C (P < 0.001). There were fewer clinic visits for any cause among the children receiving SP/AS or AQ/AS (P = 0.024). The prevalence of asymptomatic parasitemia was fivefold higher in the vitamin C arm than either SP/AS or AQ/AS at each post-treatment evaluation (P < 0.001). At the end of the transmission period, children treated with IPT had lower rates of anaemia (SP/AS, 17.7%; AQ/AS, 16.0%; vitamin C, 29.6%; P = 0.039). Conclusion IPT among school children reduced the rates of clinical malaria, all-cause acute clinic visits, asymptomatic parasitemia and anaemia among school-aged children.

AB - Objective To assess the efficacy of intermittent preventive treatment (IPT) against malaria in school-aged children. Methods This was an open randomized controlled trial of seasonal IPT among school children (IPTsc) aged 6-13 years in Kollé, Mali. The study began in September 2007 and completed follow-up in May 2008. Students were randomized to one of three study arms: Sulfadoxine-pyrimethamine plus artesunate (SP/AS), amodiaquine plus artesunate (AQ/AS) or vitamin C. All students received two full treatment doses, given 2 months apart during the season of high transmission from September to December. Groups were compared with respect to incidence of clinical malaria, asymptomatic parasitemia and haemoglobin concentration. Results A total of 296 students were randomized, and retention in the study was 99.3%. Clinical malaria incidence in the SP/AS and AQ/AS arms was reduced by 66.6% and 46.5%, respectively, vs. vitamin C (P < 0.001). There were fewer clinic visits for any cause among the children receiving SP/AS or AQ/AS (P = 0.024). The prevalence of asymptomatic parasitemia was fivefold higher in the vitamin C arm than either SP/AS or AQ/AS at each post-treatment evaluation (P < 0.001). At the end of the transmission period, children treated with IPT had lower rates of anaemia (SP/AS, 17.7%; AQ/AS, 16.0%; vitamin C, 29.6%; P = 0.039). Conclusion IPT among school children reduced the rates of clinical malaria, all-cause acute clinic visits, asymptomatic parasitemia and anaemia among school-aged children.

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