Impact of intermittent preventive treatment with sulphadoxine-pyrimethamine targeting the transmission season on the incidence of clinical malaria in children in Mali
Abstract Background Recent studies have shown that intermittent preventive malaria treatment (IPT) in infants in areas of stable malaria transmission reduces malaria and severe anaemia incidence. However in most areas malaria morbidity and mortality remain high in older children. Methods To evaluate...
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ftdoajarticles:oai:doaj.org/article:d41ad54516ac470b834f16101603325b 2023-05-15T15:15:03+02:00 Impact of intermittent preventive treatment with sulphadoxine-pyrimethamine targeting the transmission season on the incidence of clinical malaria in children in Mali Toure Ousmane B Kone Mamady Diallo Abdoulbaki I Guindo Ousmane Sissoko Mahamadou S Sagara Issaka Dicko Alassane Sacko Massambou Doumbo Ogobara K 2008-07-01T00:00:00Z https://doi.org/10.1186/1475-2875-7-123 https://doaj.org/article/d41ad54516ac470b834f16101603325b EN eng BMC http://www.malariajournal.com/content/7/1/123 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-7-123 1475-2875 https://doaj.org/article/d41ad54516ac470b834f16101603325b Malaria Journal, Vol 7, Iss 1, p 123 (2008) Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2008 ftdoajarticles https://doi.org/10.1186/1475-2875-7-123 2022-12-31T06:55:03Z Abstract Background Recent studies have shown that intermittent preventive malaria treatment (IPT) in infants in areas of stable malaria transmission reduces malaria and severe anaemia incidence. However in most areas malaria morbidity and mortality remain high in older children. Methods To evaluate the effect of seasonal IPT with sulphadoxine pyrimethamine (SP) on incidence of malaria disease in area of seasonal transmission, 262 children 6 months-10 years in Kambila, Mali were randomized to receive either IPT with SP twice at eight weeks interval or no IPT during the transmission season of 2002 and were followed up for 12 months. Subjects were also followed during the subsequent transmission season in 2003 to assess possible rebound effect. Clinical malaria cases were treated with SP and followed to assess the in vivo response during both periods. Results The incidence rate of malaria disease per 1,000 person-months during the first 12 months was 3.2 episodes in the treatment group vs. 5.8 episodes in the control group with age-adjusted Protective Efficacy (PE) of 42.5%; [95% CI 28.6%–53.8%]. When the first 16 weeks of follow up is considered age-adjusted PE was 67.5% [95% CI 55.3% – 76.6%]. During the subsequent transmission season, the incidence of clinical malaria per 1000 persons-days was similar between the two groups (23.0 vs 21.5 episodes, age-adjusted IRR = 1.07 [95% CI, 0.90–1.27]). No significant difference was detected in in vivo response between the groups during both periods. Conclusion Two malaria intermittent treatments targeting the peak transmission season reduced the annual incidence rate of clinical malaria by 42.5% in an area with intense seasonal transmission. This simple strategy is likely to be one of the most effectives in reducing malaria burden in such areas. Trial Registration Clinicaltrials.gov NCT00623155 Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 7 1 |
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Directory of Open Access Journals: DOAJ Articles |
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English |
topic |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
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Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Toure Ousmane B Kone Mamady Diallo Abdoulbaki I Guindo Ousmane Sissoko Mahamadou S Sagara Issaka Dicko Alassane Sacko Massambou Doumbo Ogobara K Impact of intermittent preventive treatment with sulphadoxine-pyrimethamine targeting the transmission season on the incidence of clinical malaria in children in Mali |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Recent studies have shown that intermittent preventive malaria treatment (IPT) in infants in areas of stable malaria transmission reduces malaria and severe anaemia incidence. However in most areas malaria morbidity and mortality remain high in older children. Methods To evaluate the effect of seasonal IPT with sulphadoxine pyrimethamine (SP) on incidence of malaria disease in area of seasonal transmission, 262 children 6 months-10 years in Kambila, Mali were randomized to receive either IPT with SP twice at eight weeks interval or no IPT during the transmission season of 2002 and were followed up for 12 months. Subjects were also followed during the subsequent transmission season in 2003 to assess possible rebound effect. Clinical malaria cases were treated with SP and followed to assess the in vivo response during both periods. Results The incidence rate of malaria disease per 1,000 person-months during the first 12 months was 3.2 episodes in the treatment group vs. 5.8 episodes in the control group with age-adjusted Protective Efficacy (PE) of 42.5%; [95% CI 28.6%–53.8%]. When the first 16 weeks of follow up is considered age-adjusted PE was 67.5% [95% CI 55.3% – 76.6%]. During the subsequent transmission season, the incidence of clinical malaria per 1000 persons-days was similar between the two groups (23.0 vs 21.5 episodes, age-adjusted IRR = 1.07 [95% CI, 0.90–1.27]). No significant difference was detected in in vivo response between the groups during both periods. Conclusion Two malaria intermittent treatments targeting the peak transmission season reduced the annual incidence rate of clinical malaria by 42.5% in an area with intense seasonal transmission. This simple strategy is likely to be one of the most effectives in reducing malaria burden in such areas. Trial Registration Clinicaltrials.gov NCT00623155 |
format |
Article in Journal/Newspaper |
author |
Toure Ousmane B Kone Mamady Diallo Abdoulbaki I Guindo Ousmane Sissoko Mahamadou S Sagara Issaka Dicko Alassane Sacko Massambou Doumbo Ogobara K |
author_facet |
Toure Ousmane B Kone Mamady Diallo Abdoulbaki I Guindo Ousmane Sissoko Mahamadou S Sagara Issaka Dicko Alassane Sacko Massambou Doumbo Ogobara K |
author_sort |
Toure Ousmane B |
title |
Impact of intermittent preventive treatment with sulphadoxine-pyrimethamine targeting the transmission season on the incidence of clinical malaria in children in Mali |
title_short |
Impact of intermittent preventive treatment with sulphadoxine-pyrimethamine targeting the transmission season on the incidence of clinical malaria in children in Mali |
title_full |
Impact of intermittent preventive treatment with sulphadoxine-pyrimethamine targeting the transmission season on the incidence of clinical malaria in children in Mali |
title_fullStr |
Impact of intermittent preventive treatment with sulphadoxine-pyrimethamine targeting the transmission season on the incidence of clinical malaria in children in Mali |
title_full_unstemmed |
Impact of intermittent preventive treatment with sulphadoxine-pyrimethamine targeting the transmission season on the incidence of clinical malaria in children in Mali |
title_sort |
impact of intermittent preventive treatment with sulphadoxine-pyrimethamine targeting the transmission season on the incidence of clinical malaria in children in mali |
publisher |
BMC |
publishDate |
2008 |
url |
https://doi.org/10.1186/1475-2875-7-123 https://doaj.org/article/d41ad54516ac470b834f16101603325b |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 7, Iss 1, p 123 (2008) |
op_relation |
http://www.malariajournal.com/content/7/1/123 https://doaj.org/toc/1475-2875 doi:10.1186/1475-2875-7-123 1475-2875 https://doaj.org/article/d41ad54516ac470b834f16101603325b |
op_doi |
https://doi.org/10.1186/1475-2875-7-123 |
container_title |
Malaria Journal |
container_volume |
7 |
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1 |
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1766345443043704832 |