title: Effect of Repeated Anthelminthic Treatment on Malaria in School Children in Kenya: A Randomized, Open-Label, Equivalence Trial.
abstract: BACKGROUND
  School children living in the tropics are often concurrently infected with plasmodium and helminth parasites. It has been hypothesized that immune responses evoked by helminths may modify malaria-specific immune responses and increase the risk of malaria.
  
  
  METHODS
  We performed a randomized, open-label, equivalence trial among 2436 school children in western Kenya. Eligible children were randomized to receive either 4 repeated doses or a single dose of albendazole and were followed up during 13 months to assess the incidence of clinical malaria. Secondary outcomes were Plasmodium prevalence and density, assessed by repeat cross-sectional surveys over 15 months. Analysis was conducted on an intention-to-treat basis with a prespecified equivalence range of 20%.
  
  
  RESULTS
  During 13 months of follow-up, the incidence rate of malaria was 0.27 episodes/person-year in the repeated treatment group and 0.26 episodes/person-year in the annual treatment group (incidence difference, 0.01; 95% confidence interval, -.03 to .06). The prevalence and density of malaria parasitemia did not differ by treatment group at any of the cross-sectional surveys.
  
  
  CONCLUSIONS
  Our findings suggest that repeated deworming does not alter risks of clinical malaria or malaria parasitemia among school children and that school-based deworming in Africa may have no adverse consequences for malaria.
  
  
  BACKGROUND
  NCT01658774.
authors.affiliation: School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Stella
authors.initials: S
authors.lastname: Kepha
authors.affiliation: School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
authors.forename: Fred
authors.initials: F
authors.lastname: Nuwaha
authors.affiliation: London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Birgit
authors.initials: B
authors.lastname: Nikolay
authors.affiliation: Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI).
authors.forename: Paul
authors.initials: P
authors.lastname: Gichuki
authors.affiliation: Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI).
authors.forename: Charles S
authors.initials: CS
authors.lastname: Mwandawiro
authors.affiliation: Neglected Tropical Diseases Research Unit, Center for Global Health Research, KEMRI, Kisumu, Kenya.
authors.forename: Pauline N
authors.initials: PN
authors.lastname: Mwinzi
authors.affiliation: Neglected Tropical Diseases Research Unit, Center for Global Health Research, KEMRI, Kisumu, Kenya.
authors.forename: Maurice R
authors.initials: MR
authors.lastname: Odiere
authors.affiliation: London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Tansy
authors.initials: T
authors.lastname: Edwards
authors.affiliation: London School of Hygiene and Tropical Medicine, United Kingdom.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Allen
authors.affiliation: London School of Hygiene and Tropical Medicine, United Kingdom KEMRI-Wellcome Trust Research Programme, Nairobi.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Brooker
mesh_terms: D000293:Adolescent; D015766:Albendazole / Q000008:administration & dosage / Q000627:therapeutic use*; D000871:Anthelmintics / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D004334:Drug Administration Schedule; D005260:Female; D006373:Helminthiasis / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control*; D008297:Male; D018512:Parasitemia; D012307:Risk Factors
chemical_list: D000871:Anthelmintics; D015766:Albendazole
keywords: Kenya; deworming; helminths; malaria; school children