PMID- 17638703
OWN - NLM
STAT- MEDLINE
DCOM- 20080108
LR  - 20181113
IS  - 0066-4804 (Print)
IS  - 1098-6596 (Electronic)
IS  - 0066-4804 (Linking)
VI  - 51
IP  - 9
DP  - 2007 Sep
TI  - Intermittent preventive treatment in infants as a means of malaria control: a 
      randomized, double-blind, placebo-controlled trial in northern Ghana.
PG  - 3273-81
AB  - Morbidity and mortality from malaria remain unacceptably high among young 
      children in sub-Saharan Africa. Intermittent preventive treatment in infancy 
      (IPTi) involves the administration of antimalarials alongside routine 
      vaccinations and might be an option in malaria control. In an area of intense, 
      perennial malaria transmission in northern Ghana, 1,200 children received IPTi 
      with sulfadoxine-pyrimethamine or placebo at approximately 3, 9, and 15 months of 
      age. Children were followed up until 24 months of age to assess morbidity and 
      adverse events. During the intervention period (3 to 18 months of age), IPTi 
      reduced the incidences of malaria and severe anemia by 22.5% (95% confidence 
      interval, 12 to 32%) and 23.6% (95% confidence interval, 4 to 39%), respectively, 
      and reduced hospitalizations and episodes of asymptomatic parasitemia by 
      one-third. Protection was pronounced in the first year of life and not 
      discernible in the second. The malaria-protective effect was largely confined to 
      a period of 1 month after sulfadoxine-pyrimethamine treatments. Following the 
      intervention, protection against asymptomatic parasitemia persisted. In contrast, 
      a significant rebound of severe malaria, predominantly severe malarial anemia, 
      occurred among children having received IPTi. Although the treatment was 
      generally well tolerated, one case of moderately severe skin reaction followed 
      sulfadoxine-pyrimethamine treatment. IPTi reduces malaria and anemia in infants 
      in northern Ghana. Extension of IPTi into the second year of life by 
      administering a dose at 15 months of age provided no substantial benefit beyond a 
      1-month prophylactic effect. Although this simple intervention offers one of the 
      few available malaria-preventive measures for regions where malaria is endemic, 
      the observed rebound of severe malaria advises caution and requires further 
      investigation.
FAU - Mockenhaupt, Frank P
AU  - Mockenhaupt FP
AD  - Institute of Tropical Medicine and International Health, Charite--University 
      Medicine Berlin, Berlin, Germany. frank.mockenhaupt@charite.de
FAU - Reither, Klaus
AU  - Reither K
FAU - Zanger, Philipp
AU  - Zanger P
FAU - Roepcke, Felix
AU  - Roepcke F
FAU - Danquah, Ina
AU  - Danquah I
FAU - Saad, Eiman
AU  - Saad E
FAU - Ziniel, Peter
AU  - Ziniel P
FAU - Dzisi, Stephen Y
AU  - Dzisi SY
FAU - Frempong, Marc
AU  - Frempong M
FAU - Agana-Nsiire, Patrick
AU  - Agana-Nsiire P
FAU - Amoo-Sakyi, Felicia
AU  - Amoo-Sakyi F
FAU - Otchwemah, Rowland
AU  - Otchwemah R
FAU - Cramer, Jakob P
AU  - Cramer JP
FAU - Anemana, Sylvester D
AU  - Anemana SD
FAU - Dietz, Ekkehart
AU  - Dietz E
FAU - Bienzle, Ulrich
AU  - Bienzle U
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20070716
PL  - United States
TA  - Antimicrob Agents Chemother
JT  - Antimicrobial agents and chemotherapy
JID - 0315061
RN  - 0 (Antimalarials)
RN  - 0 (Drug Combinations)
RN  - 88463U4SM5 (Sulfadoxine)
RN  - Z3614QOX8W (Pyrimethamine)
SB  - IM
EIN - Antimicrob Agents Chemother. 2012 Jan;56(1):600. Dosage error in article text
MH  - Anemia/epidemiology/etiology
MH  - Antimalarials/*therapeutic use
MH  - Data Interpretation, Statistical
MH  - Double-Blind Method
MH  - Drug Combinations
MH  - Female
MH  - Follow-Up Studies
MH  - Ghana/epidemiology
MH  - Hospitalization
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Infection Control/*methods
MH  - Malaria/complications/epidemiology/*prevention & control
MH  - Male
MH  - Pyrimethamine/*therapeutic use
MH  - Sulfadoxine/*therapeutic use
MH  - Treatment Outcome
PMC - PMC2043181
EDAT- 2007/07/20 09:00
MHDA- 2008/01/09 09:00
PMCR- 2008/01/01
CRDT- 2007/07/20 09:00
PHST- 2007/07/20 09:00 [pubmed]
PHST- 2008/01/09 09:00 [medline]
PHST- 2007/07/20 09:00 [entrez]
PHST- 2008/01/01 00:00 [pmc-release]
AID - AAC.00513-07 [pii]
AID - 0513-07 [pii]
AID - 10.1128/AAC.00513-07 [doi]
PST - ppublish
SO  - Antimicrob Agents Chemother. 2007 Sep;51(9):3273-81. doi: 10.1128/AAC.00513-07. 
      Epub 2007 Jul 16.