PMID- 16195288
OWN - NLM
STAT- MEDLINE
DCOM- 20051011
LR  - 20240314
IS  - 1756-1833 (Electronic)
IS  - 0959-8138 (Print)
IS  - 0959-8138 (Linking)
VI  - 331
IP  - 7519
DP  - 2005 Oct 1
TI  - Cluster randomised trial of intermittent preventive treatment for malaria in 
      infants in area of high, seasonal transmission in Ghana.
PG  - 727-33
AB  - OBJECTIVE: To evaluate the effects of intermittent preventive treatment for 
      malaria in infants (IPTi) with sulfadoxine-pyrimethamine in an area of intense, 
      seasonal transmission. DESIGN: Cluster randomised placebo controlled trial, with 
      96 clusters allocated randomly to sulfadoxine-pyrimethamine or placebo in blocks 
      of eight. INTERVENTIONS: Children received sulfadoxine-pyrimethamine or placebo 
      and one month of iron supplementation when they received DPT-2, DPT-3, or measles 
      vaccinations and at 12 months of age. MAIN OUTCOME MEASURES: Incidence of malaria 
      and of anaemia determined through passive case detection. RESULTS: 89% 
      (1103/1242) of children in the placebo group and 88% (1088/1243) in the IPTi 
      group completed follow-up to 24 months of age. The protective efficacy of IPTi 
      against all episodes of malaria was 24.8% (95% confidence interval 14.3% to 
      34.0%) up to 15 months of age. IPTi had no protective effect against malaria 
      between 16 and 24 months of age (protective efficacy -4.9%, -21.3% to 9.3%). The 
      incidence of high parasite density malaria (> or = 5000 parasites/mul) was higher 
      in the IPTi group than in the placebo group between 16 and 24 months of age 
      (protective efficacy -19.5%, -39.8% to -2.2%). IPTi reduced hospital admissions 
      with anaemia by 35.1% (10.5% to 52.9%) up to 15 months of age. IPTi had no 
      significant effect on anaemia between 16 and 24 months of age (protective 
      efficacy -6.4%, -76.8% to 35.9%). The relative risk of death up to 15 months of 
      age in the IPTi group was 1.26 (95% confidence interval 0.81 to 1.96; P = 0.31), 
      and from 16 to 24 months it was 1.28 (0.77 to 2.14; P = 0.35). CONCLUSIONS: 
      Intermittent preventive treatment for malaria with sulfadoxine-pyrimethamine can 
      reduce malaria and anaemia in infants even in seasonal, high transmission areas, 
      but concern exists about possible rebound in the incidence of malaria in the 
      second year of life.
FAU - Chandramohan, Daniel
AU  - Chandramohan D
AD  - London School of Hygiene and Tropical Medicine, London WC1E 7HT. 
      daniel.chandramohan@lshtm.ac.uk
FAU - Owusu-Agyei, Seth
AU  - Owusu-Agyei S
FAU - Carneiro, Ilona
AU  - Carneiro I
FAU - Awine, Timothy
AU  - Awine T
FAU - Amponsa-Achiano, Kwame
AU  - Amponsa-Achiano K
FAU - Mensah, Nathan
AU  - Mensah N
FAU - Jaffar, Shabbar
AU  - Jaffar S
FAU - Baiden, Rita
AU  - Baiden R
FAU - Hodgson, Abraham
AU  - Hodgson A
FAU - Binka, Fred
AU  - Binka F
FAU - Greenwood, Brian
AU  - Greenwood B
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - BMJ
JT  - BMJ (Clinical research ed.)
JID - 8900488
RN  - 0 (Antimalarials)
RN  - 0 (Drug Combinations)
RN  - 37338-39-9 (fanasil, pyrimethamine drug combination)
RN  - 88463U4SM5 (Sulfadoxine)
RN  - Z3614QOX8W (Pyrimethamine)
SB  - IM
MH  - Anemia/mortality/parasitology
MH  - Antimalarials/*therapeutic use
MH  - Cluster Analysis
MH  - Drug Combinations
MH  - Ghana/epidemiology
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Malaria/mortality/*prevention & control
MH  - Parasitemia/epidemiology
MH  - Prevalence
MH  - Pyrimethamine/*therapeutic use
MH  - Seasons
MH  - Sulfadoxine/*therapeutic use
MH  - Treatment Outcome
PMC - PMC1239974
EDAT- 2005/10/01 09:00
MHDA- 2005/10/12 09:00
PMCR- 2005/10/01
CRDT- 2005/10/01 09:00
PHST- 2005/10/01 09:00 [pubmed]
PHST- 2005/10/12 09:00 [medline]
PHST- 2005/10/01 09:00 [entrez]
PHST- 2005/10/01 00:00 [pmc-release]
AID - 331/7519/727 [pii]
AID - 03310727 [pii]
AID - 10.1136/bmj.331.7519.727 [doi]
PST - ppublish
SO  - BMJ. 2005 Oct 1;331(7519):727-33. doi: 10.1136/bmj.331.7519.727.