Effectiveness of combined intermittent preventive treatment for children and timely home treatment for malaria control.
BACKGROUND
Whiles awaiting for the arrival of an effective and affordable malaria vaccine, there is a need to make use of the available control tools to reduce malaria risk, especially in children under five years and pregnant women. Intermittent preventive treatment (IPT) has recently been accepted as an important component of the malaria control strategy. This study explored the potential of a strategy of intermittent preventive treatment for children (IPTC) and timely treatment of malaria-related febrile illness in the home in reducing the parasite prevalence and malaria morbidity in young children in a coastal village in Ghana.


METHODS
The study combined home-based delivery of IPTC among six to 60 months old and home treatment of suspected febrile malaria illness within 24 hours. All children between six and 60 months of age received intermittent preventive treatment using amodiaquine and artesunate, delivered by community assistants every four months (three times in 12 months). Malaria parasite prevalence surveys were conducted before the first and after the third dose of IPTC.


RESULTS
Parasite prevalence was reduced from 25% to 3% (p < 0.00, Mann-Whitney) one year after the inception of the two interventions. At baseline, 13.8% of the children were febrile (axillary temperature greater than or equal to 37.5 degree Celsius) compared to 2.2% at evaluation (post IPTC3 combined with timely home management of fever) (p < 0.00, Mann-Whitney).


CONCLUSIONS
The evaluation result indicates that IPTC given three times in a year combined with timely treatment of febrile malaria illness, impacts significantly on the parasite prevalence. The marked reduction in the parasite prevalence with this strategy points to the potential for reducing malaria-related childhood morbidity and mortality, and this should be explored by control programme managers.
Ahorlu
Collins K
CK
Noguchi Memorial Institute for Medical Research, University of Ghana, Box LG581, Legon, Ghana. cahorlu@noguchi.mimcom.org
Koram
Kwadwo A
KA
Seakey
Atsu K
AK
Weiss
Mitchell G
MG
D000328:Adult; D000655:Amodiaquine / Q000008:administration & dosage*; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage*; D037621:Artemisinins / Q000008:administration & dosage*; D000077332:Artesunate; D017028:Caregivers; D002675:Child, Preschool; D004334:Drug Administration Schedule; D005260:Female; D005334:Fever / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D018512:Parasitemia / Q000453:epidemiology / Q000517:prevention & control*; D010963:Plasmodium falciparum / Q000302:isolation & purification; D015995:Prevalence; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D000962:Antimalarials; D037621:Artemisinins; D000655:Amodiaquine; D000077332:Artesunate