Intermittent Preventive Treatment for Malaria Control Administered at the Time of Routine Vaccinations in Mozambican Infants: A Randomized, Placebo-Controlled Trial

BackgroundThere is an urgent need to deploy and develop new control tools that will reduce the intolerable burden of malaria. Intermittent preventive treatment in infants (IPTi) has the potential to become an effective tool for malaria control MethodsWe performed a randomized, double-blind, placebo-...

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Bibliographic Details
Published in:The Journal of infectious diseases 2006-08, Vol.194 (3), p.276-285
Main Authors: Macete, Eusebio, Aide, Pedro, Aponte, John J., Sanz, Sergi, Mandomando, Inacio, Espasa, Mateu, Sigauque, Betuel, Dobaño, Carlota, Mabunda, Samuel, DgeDge, Martinho, Alonso, Pedro, Menendez, Clara
Format: Article
Language:English
Subjects:
Anemia
Animals
Antibodies
Antimalarials - administration & dosage
Antimalarials - adverse effects
Chemoprevention
Child, Preschool
Children
Cross-Sectional Studies
Dosage
Double-Blind Method
Drug Combinations
Female
Hospital admissions
Humans
Infant
Infants
Malaria
Malaria, Falciparum - drug therapy
Malaria, Falciparum - parasitology
Malaria, Falciparum - prevention & control
Male
Measles
Parasites
Placebos
Plasmodium falciparum - growth & development
Pyrimethamine - administration & dosage
Pyrimethamine - adverse effects
Sulfadoxine - administration & dosage
Sulfadoxine - adverse effects
Vaccination
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Summary:BackgroundThere is an urgent need to deploy and develop new control tools that will reduce the intolerable burden of malaria. Intermittent preventive treatment in infants (IPTi) has the potential to become an effective tool for malaria control MethodsWe performed a randomized, double-blind, placebo-controlled trial of sulfadoxine-pyrimethamine (SP) treatment in 1503 Mozambican children. Doses of SP or placebo were given at 3, 4, and 9 months of age. The intervention was administered alongside routine vaccinations delivered through the Expanded Program on Immunization (EPI). Hematological and biochemical tests were done when infants were 5 months old. Morbidity monitoring through a hospital-based passive case-detection system was complemented by cross-sectional surveys when infants were 12 and 24 months old ResultsIPTi was well tolerated, and no adverse events associated with SP were documented. During the first year of life, intermittent SP treatment reduced the incidence of clinical malaria by 22.2% (95% confidence interval [CI], 3.7%–37.0%; P=.020) and the rate of hospital admissions by 19% (95% CI, 4.0%–31.0%; P=.014). Although the incidence of severe anemia (packed cell volume of
ISSN:0022-1899
1537-6613
DOI:10.1086/505431