Efficacy of atovaquone/proguanil for malaria prophylaxis in children and its effect on the immunogenicity of live oral typhoid and cholera vaccines.
A double-blind, placebo-controlled study was conducted to measure the impact of malaria prophylaxis with atovaquone/proguanil (A-P) on the immunogenicity of vaccines against typhoid fever and cholera, Salmonella serotype Typhi Ty21a and Vibrio cholerae CVD103-HgR, respectively. A total of 330 Gabonese schoolchildren were assigned to receive either A-P or placebo for 12 weeks. Vaccination occurred 3 weeks after the start of prophylaxis, and immunogenicity was assessed 4 weeks after vaccination. The protective efficacy of A-P against Plasmodium falciparum malaria was of 97% (95% confidence interval, 79%-100%). The 2 treatment groups did not differ significantly with regard to changes in antibody titers after vaccination (P=.96 for anti-S. Typhi IgG antibodies, P=.07 for anti-S. Typhi IgA antibodies, and P=.64 for vibriocidal antibodies). The A-P combination was highly effective for malaria prophylaxis, without interfering with the in vivo immunogenicity of CVD103-HgR and Ty21a vaccines, and it could therefore be simultaneously administered with these vaccines.
Faucher
Jean-François
JF
Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon.
Binder
Ronnie
R
Missinou
Michel A
MA
Matsiegui
Pierre-Blaise
PB
Gruss
Holger
H
Neubauer
Rajko
R
Lell
Bertrand
B
Que
John U
JU
Miller
Gerri B
GB
Kremsner
Peter G
PG
D000284:Administration, Oral; D000293:Adolescent; D000962:Antimalarials / Q000494:pharmacology / Q000627:therapeutic use*; D053626:Atovaquone; D018890:Chemoprevention; D002648:Child; D002675:Child, Preschool; D022121:Cholera Vaccines / Q000008:administration & dosage / Q000276:immunology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007109:Immunity / Q000187:drug effects*; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D009285:Naphthoquinones / Q000494:pharmacology / Q000627:therapeutic use*; D002727:Proguanil / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D014436:Typhoid-Paratyphoid Vaccines / Q000008:administration & dosage / Q000276:immunology*
D000962:Antimalarials; D022121:Cholera Vaccines; D009285:Naphthoquinones; D014436:Typhoid-Paratyphoid Vaccines; D002727:Proguanil; D053626:Atovaquone