Intermittent preventive antimalarial treatment for Tanzanian infants: follow-up to age 2 years of a randomised, placebo-controlled trial.
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.
Schellenberg
David
D
Centre for International Health, Institut d'Investigacions Biomedicas August Pi I Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain. dmschellenberg@aol.com
Menendez
Clara
C
Aponte
John J
JJ
Kahigwa
Elizeus
E
Tanner
Marcel
M
Mshinda
Hassan
H
Alonso
Pedro
P
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*
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine