Seasonal intermittent preventive treatment with artesunate and sulfadoxine-pyrimethamine for prevention of malaria in Senegalese children: a randomised, placebo-controlled, double-blind trial.
- Department for International Development
- 1 January 2006
- Document Type:
- Journal Article
- Trape, J.F., Greenwood, B., Lines, J., Alexander, N., Gaye, O. Cissé, B., Sokhna, C., Boulanger, D., Milet, J., Bâ, el H., Richardson, K., Hallett, R., Sutherland, C., Simondon, K., Simondon, F., and Targett, G.
BACKGROUND: In the Sahel and sub-Sahelian regions of Africa, malaria transmission is highly seasonal. During a short period of high malaria transmission, mortality and morbidity are high in children under age 5 years. We assessed the efficacy of seasonal intermittent preventive treatment-a full dose of antimalarial treatment given at defined times without previous testing for malaria infection.
METHODS: We did a randomised, placebo-controlled, double-blind trial of the effect of intermittent preventive treatment on morbidity from malaria in three health-care centres in Niakhar, a rural area of Senegal. 1136 children aged 2-59 months received either one dose of artesunate plus one dose of sulfadoxine-pyrimethamine or two placebos on three occasions during the malaria transmission season. The primary outcome was a first or single episode of clinical malaria detected through active or passive case detection. Primary analysis was by intention-to-treat. This study is registered with , number NCT00132561.
FINDINGS: During 13 weeks of follow-up, the intervention led to an 86% (95% CI 80-90) reduction in the occurrence of clinical episodes of malaria. With passive case detection, protective efficacy against malaria was 86% (77-92), and when detected actively was 86% (78-91). The incidence of malaria in children on active drugs was 308 episodes per 1000 person-years at risk, whereas in those on placebo it was 2250 episodes per 1000 person-years at risk. 13 children were not included in the intention-to-treat analysis, which was restricted to children who received a first dose of antimalarial or placebo. There was an increase in vomiting in children who received the active drugs, but generally the intervention was well tolerated.
INTERPRETATION: Intermittent preventive treatment could be highly effective for prevention of malaria in children under 5 years of age living in areas of seasonal malaria infection.
Lancet (2006) 367 (9511) 659-667 [doi:10.1016/S0140-6736(06)68264-0]
Published: 1 January 2006
Document Type: Journal Article
Authors: Trape, J.F. Greenwood, B. Lines, J. Alexander, N. Gaye, O. Cissé, B. Sokhna, C. Boulanger, D. Milet, J. Bâ, el H. Richardson, K. Hallett, R. Sutherland, C. Simondon, K. Simondon, F. Targett, G.