Community effectiveness of intermittent preventive treatment for infants (IPTi) in rural southern Tanzania.
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.
Armstrong Schellenberg
Joanna R M
JR
London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT. Joanna.schellenberg@lshtm.ac.uk
Shirima
Kizito
K
Maokola
Werner
W
Manzi
Fatuma
F
Mrisho
Mwifadhi
M
Mushi
Adiel
A
Mshinda
Hassan
H
Alonso
Pedro
P
Tanner
Marcel
M
Schellenberg
David M
DM
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
D000962:Antimalarials