title: Efficacy and safety of intermittent preventive treatment for malaria in schoolchildren: a systematic review.
abstract: BACKGROUND
  Intermittent preventive treatment (IPT) is a proven malaria control strategy in infants and pregnancy. School-aged children represent 26 % of the African population, and an increasing percentage of them are scholarized. Malaria is causing 50 % of deaths in this age group and malaria control efforts may shift the malaria burden to older age groups. Schools have been suggested as a platform for health interventions delivery (deworming, iron-folic acid, nutrients supplementation, (boost-)immunization) and as a possible delivery system for IPT in schoolchildren (IPTsc). However, the current evidence on the efficacy and safety of IPTsc is limited and the optimal therapeutic regimen remains controversial.
  
  
  METHODS
  A systematic search for studies reporting efficacy and safety of IPT in schoolchildren was conducted using PubMed, Web of Science, Clinicaltrials and WHO/ICTRP database, and abstracts from congresses with the following key words: intermittent, preventive treatment AND malaria OR Plasmodium falciparum AND schoolchildren NOT infant NOT pregnancy.
  
  
  RESULTS
  Five studies were identified. Most IPTsc regimes demonstrated substantial protection against malaria parasitaemia, with dihydroartemisinin-piperaquine (DP) given monthly having the highest protective effect (PE) (94 %; 95 % CI 93-96). Contrarily, SP did not provide any PE against parasitaemia. However, no IPT regimen provided a PE above 50 % in regard to anaemia, and highest protection was provided by SP+ amodiaquine (AQ) given four-monthly (50 %; 95 % CI 41-53). The best protection against clinical malaria was observed in children monthly treated with DP (97 %; 95 % CI 87-98). However, there was no protection when the drug was given three-monthly. No severe adverse events were associated with the drugs used for IPTsc.
  
  
  CONCLUSIONS
  IPTsc may reduce the malaria-related burden in schoolchildren. However, more studies assessing efficacy of IPT in particular against malaria-related anaemia and clinical malaria in schoolchildren must be conducted.
authors.affiliation: Département de Médecine Tropicale, Faculté de Médecine, Université de Kinshasa, BP 747, Kinshasa, XI, Democratic Republic of the Congo. matangilaj@yahoo.fr.|Epidemiology for Global Health Institute, University of Antwerp, Campus DrieEiken, Universiteitsplein 1, Wilrijk, 2610, Belgium. matangilaj@yahoo.fr.
authors.forename: Junior R
authors.initials: JR
authors.lastname: Matangila
authors.affiliation: Département de Médecine Tropicale, Faculté de Médecine, Université de Kinshasa, BP 747, Kinshasa, XI, Democratic Republic of the Congo. pmitashi@yahoo.fr.
authors.forename: Patrick
authors.initials: P
authors.lastname: Mitashi
authors.affiliation: Epidemiology for Global Health Institute, University of Antwerp, Campus DrieEiken, Universiteitsplein 1, Wilrijk, 2610, Belgium. raquel.daluz@uantwerpen.be.
authors.forename: Raquel A
authors.initials: RA
authors.lastname: Inocêncio da Luz
authors.affiliation: Département de Médecine Tropicale, Faculté de Médecine, Université de Kinshasa, BP 747, Kinshasa, XI, Democratic Republic of the Congo. pascal_lutumba@yahoo.fr.
authors.forename: Pascal T
authors.initials: PT
authors.lastname: Lutumba
authors.affiliation: Epidemiology for Global Health Institute, University of Antwerp, Campus DrieEiken, Universiteitsplein 1, Wilrijk, 2610, Belgium. Jean-Pierre.VanGeertruyden@uantwerpen.be.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Van Geertruyden
mesh_terms: D000293:Adolescent; D000349:Africa; D000962:Antimalarials / Q000008:administration & dosage* / Q000009:adverse effects*; D018890:Chemoprevention / Q000009:adverse effects* / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D012574:Schools; D013334:Students; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials