title: Intermittent preventive antimalarial treatment for Tanzanian infants: follow-up to age 2 years of a randomised, placebo-controlled trial.
abstract: Stopping antimalarial chemoprophylaxis can be followed by increased risk of malaria, suggesting that it interferes with the development of antimalarial immunity. We report analysis of extended follow-up until age 2 years of a randomised, placebo-controlled double-blind trial of intermittent preventive antimalarial treatment in infants. The rate of clinical malaria (events per person-year at risk, starting 1 month after final dose of intermittent treatment) was 0.28 in the sulfadoxine-pyrimethamine group and 0.43 in the placebo group (protective effect 36%, 95% CI 11-53). Intermittent treatment produced a sustained reduction in the risk of clinical malaria extending well beyond the duration of the pharmacological effects of the drugs, excluding a so-called rebound effect and suggesting that such treatment could facilitate development of immunity against Plasmodium falciparum.
authors.affiliation: Centre for International Health, Institut d'Investigacions Biomedicas August Pi I Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain. dmschellenberg@aol.com
authors.forename: David
authors.initials: D
authors.lastname: Schellenberg
authors.forename: Clara
authors.initials: C
authors.lastname: Menendez
authors.forename: John J
authors.initials: JJ
authors.lastname: Aponte
authors.forename: Elizeus
authors.initials: E
authors.lastname: Kahigwa
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.forename: Hassan
authors.initials: H
authors.lastname: Mshinda
authors.forename: Pedro
authors.initials: P
authors.lastname: Alonso
mesh_terms: D000962:Antimalarials / Q000008:administration & dosage*; D002675:Child, Preschool; D004338:Drug Combinations; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000517:prevention & control*; D011739:Pyrimethamine / Q000008:administration & dosage*; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D013413:Sulfadoxine / Q000008:administration & dosage*
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine