TY - JOUR
T1 - Intermittent preventive treatment using artemisinin-based combination therapy reduces malaria morbidity among school-aged children in Mali
AU - Barger, Breanna
AU - Maiga, Hamma
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.
PY - 2009/7
Y1 - 2009/7
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.
KW - Artemisinin
KW - Children
KW - Intermittent preventive treatment
KW - Malaria
KW - School
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U2 - 10.1111/j.1365-3156.2009.02294.x
DO - 10.1111/j.1365-3156.2009.02294.x
M3 - Article
C2 - 19497079
AN - SCOPUS:68149172721
SN - 1360-2276
VL - 14
SP - 784
EP - 791
JO - Tropical Medicine and International Health
JF - Tropical Medicine and International Health
IS - 7
ER -