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 journalArticlepeer-review

27 Scopus citations

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

Keywords

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

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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