Is the Expanded Programme on Immunisation the most appropriate delivery system for intermittent preventive treatment of malaria in West Africa?
OBJECTIVE
To investigate the coverage and equity of the Expanded Programme on Immunisation (EPI) and its effect on age schedule, seasonality of malaria risk, and linked intermittent preventive treatment (IPT) in West Africa.


METHODS
Secondary analyses of data from a trial of IPT in Ghana. The potential effectiveness and impact of EPI-linked IPT in West Africa was calculated using the coverage of Diptheria Pertussis Tetanus vaccination obtained from national surveys and the reported protective efficacies of IPT.


RESULTS
In West Africa, where the transmission of malaria is highly seasonal, only 10% of malaria episodes in infants would be averted with the current coverage of EPI.


CONCLUSIONS
In this setting, the EPI-linked IPT is not necessarily the most appropriate approach and alternative IPT schedules and delivery systems are needed.
Chandramohan
Daniel
D
London School of Hygiene and Tropical Medicine, London, UK. daniel.chandramohan@lshtm.ac.uk
Webster
Jayne
J
Smith
Lucy
L
Awine
Timothy
T
Owusu-Agyei
Seth
S
Carneiro
Ilona
I
D000354:Africa, Western / Q000453:epidemiology; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000379:methods*; D006801:Humans; D017589:Immunization Programs / Q000379:methods*; D015994:Incidence; D007223:Infant; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D017780:Malaria Vaccines / Q000627:therapeutic use; D009035:Mothers / Q000523:psychology; D012621:Seasons; D016896:Treatment Outcome
D017780:Malaria Vaccines