Seasonal intermittent preventive treatment with artesunate and sulfadoxine-pyrimethamine for prevention of malaria in Senegalese children: a randomised, placebo-controlled, double-blind trial.
In: Lancet, Jg. 367 (2006-02-25), Heft 9511, S. 659-667
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Summary: 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 randomized, placebo-controlled, double-blind trial of the effect of intermittent preventive treatment on morbidity from malaria in three health-care centers 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 ClinicalTrials.gov, 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. [ABSTRACT FROM AUTHOR]
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Seasonal intermittent preventive treatment with artesunate and sulfadoxine-pyrimethamine for prevention of malaria in Senegalese children: a randomised, placebo-controlled, double-blind trial.
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Autor/in / Beteiligte Person: | Cissé, Badara ; Sokhna, Cheikh ; Boulanger, Denis ; Milet, Jacqueline ; Bâ, El Hadj ; Richardson, Keshena ; Hallett, Rachel ; Sutherland, Colin ; Simondon, Kirsten ; Simondon, François ; Alexander, Neal ; Gaye, Oumar ; Targett, Geoffrey ; Lines, Jo ; Greenwood, Brian ; Trape, Jean-François |
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Zeitschrift: | Lancet, Jg. 367 (2006-02-25), Heft 9511, S. 659-667 |
Veröffentlichung: | 2006 |
Medientyp: | academicJournal |
ISSN: | 0140-6736 (print) |
DOI: | 10.1016/S0140-6736(06)68264-0 |
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