Seasonal intermittent treatment highly effective for preventing malaria in children under five

Intermittent antimalarial treatment could be highly effective for the prevention of malaria in children under five years living in areas of seasonal transmission, according to the results of a randomised trial in this week's issue of The Lancet.

In certain regions of Africa malaria transmission is highly seasonal. During a short period of high malaria transmission, illness and death are high in children under five years of age. Several studies have shown that giving African children anti-malaria drugs on a regular basis can protect them from the disease. However, this approach is difficult to sustain and could contribute to drug resistance.

In their trial Badara Cisse (London School of Hygiene & Tropical Medicine, UK) and colleagues (University of Dakar, Senegal, and the French Research for Development Institute, Dakar, Senegal) assessed the effect of seasonal intermittent preventive treatment in 1088 children under five in Senegal. Seasonal intermittent preventive treatment consists of a full dose of antimalarial treatment given at defined times without previous testing for malaria infection. Half the children were assigned a placebo and half the intermittent preventive treatment (artesunate plus sulfadoxine-pyrimethamine) on three occasions during the malaria transmission season. During 13 weeks' follow-up, the investigators found the intervention led to an 86% reduction in the occurrence of clinical episodes of malaria.

Dr Cisse states: "The results of this trial are very encouraging and further studies on methods of delivery, choice of drugs, and cost effectiveness of intermittent preventive treatment in children are merited."


Contact: Joe Santangelo

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