title: Community effectiveness of intermittent preventive treatment for infants (IPTi) in rural southern Tanzania.
abstract: Intermittent preventive treatment of malaria in infants (IPTi) with sulphadoxine-pyrimethamine shows evidence of efficacy in individually randomized, controlled trials. In a large-scale effectiveness study, IPTi was introduced in April 2005 by existing health staff through routine contacts in 12 randomly selected divisions out of 24 in 6 districts of rural southern Tanzania. Coverage and effects on malaria and anemia were estimated through a representative survey in 2006 with 600 children aged 2-11 months. Coverage of IPTi was 47-76% depending on the definition. Using an intention to treat analysis, parasitemia prevalence was 31% in intervention and 38% in comparison areas (P = 0.06). In a "per protocol" analysis of children who had recently received IPTi, parasite prevalence was 22%, 19 percentage points lower than comparison children (P = 0.01). IPTi can be implemented on a large scale by existing health service staff, with a measurable population effect on malaria, within 1 year of launch.
authors.affiliation: London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT. Joanna.schellenberg@lshtm.ac.uk
authors.forename: Joanna R M
authors.initials: JR
authors.lastname: Armstrong Schellenberg
authors.forename: Kizito
authors.initials: K
authors.lastname: Shirima
authors.forename: Werner
authors.initials: W
authors.lastname: Maokola
authors.forename: Fatuma
authors.initials: F
authors.lastname: Manzi
authors.forename: Mwifadhi
authors.initials: M
authors.lastname: Mrisho
authors.forename: Adiel
authors.initials: A
authors.lastname: Mushi
authors.forename: Hassan
authors.initials: H
authors.lastname: Mshinda
authors.forename: Pedro
authors.initials: P
authors.lastname: Alonso
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.forename: David M
authors.initials: DM
authors.lastname: Schellenberg
mesh_terms: D000740:Anemia / Q000517:prevention & control; D000962:Antimalarials / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D012424:Rural Population; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology
chemical_list: D000962:Antimalarials