PMID- 21767403
OWN - NLM
STAT- MEDLINE
DCOM- 20111212
LR  - 20231104
IS  - 1471-2458 (Electronic)
IS  - 1471-2458 (Linking)
VI  - 11
DP  - 2011 Jul 18
TI  - Increase in EPI vaccines coverage after implementation of intermittent preventive 
      treatment of malaria in infant with Sulfadoxine -pyrimethamine in the district of 
      Kolokani, Mali: results from a cluster randomized control trial.
PG  - 573
LID - 10.1186/1471-2458-11-573 [doi]
AB  - BACKGROUND: Even though the efficacy of Intermittent Preventive Treatment in 
      infants (IPTi) with Sulfadoxine-Pyrimethamine (SP) against clinical disease and 
      the absence of its interaction with routine vaccines of the Expanded Immunization 
      Programme (EPI) have been established, there are still some concerns regarding 
      the addition of IPTi, which may increase the work burden and disrupt the routine 
      EPI services especially in Africa where the target immunization coverage remains 
      to be met. However IPTi may also increase the adherence of the community to EPI 
      services and improve EPI coverage, once the benefice of strategy is perceived. 
      METHODS: To assess the impact of IPTi implementation on the coverage of EPI 
      vaccines, 22 health areas of the district of Kolokani were randomized at a 1:1 
      ratio to either receive IPTi-SP or to serve as a control. The EPI vaccines 
      coverage was assessed using cross-sectional surveys at baseline in November 2006 
      and after one year of IPTi pilot-implementation in December 2007. RESULTS: At 
      baseline, the proportion of children of 9-23 months who were completely 
      vaccinated (defined as children who received BGG, 3 doses of DTP/Polio, measles 
      and yellow fever vaccines) was 36.7% (95% CI 25.3% -48.0%). After one year of 
      implementation of IPTi-SP using routine health services, the proportion of 
      children completely vaccinated rose to 53.8% in the non intervention zone and 
      69.5% in the IPTi intervention zone (P <0.001).The proportion of children in the 
      target age groups who received IPTi with each of the 3 vaccinations DTP2, DTP3 
      and Measles, were 89.2% (95% CI 85.9%-92.0%), 91.0% (95% CI 87.6% -93.7%) and 
      77.4% (95% CI 70.7%-83.2%) respectively. The corresponding figures in non 
      intervention zone were 2.3% (95% CI 0.9% -4.7%), 2.6% (95% CI 1.0% -5.6%) and 
      1.7% (95% CI 0.4% - 4.9%). CONCLUSION: This study shows that high coverage of the 
      IPTi can be obtained when the strategy is implemented using routine health 
      services and implementation results in a significant increase in coverage of EPI 
      vaccines in the district of Kolokani, Mali.
FAU - Dicko, Alassane
AU  - Dicko A
AD  - Malaria Research and Training Center, Department of Epidemiology of Parasitic 
      Diseases, University of Bamako, Mali. adicko@mrtcbko.org
FAU - Toure, Sidy O
AU  - Toure SO
FAU - Traore, Mariam
AU  - Traore M
FAU - Sagara, Issaka
AU  - Sagara I
FAU - Toure, Ousmane B
AU  - Toure OB
FAU - Sissoko, Mahamadou S
AU  - Sissoko MS
FAU - Diallo, Alpha T
AU  - Diallo AT
FAU - Rogier, Christophe
AU  - Rogier C
FAU - Salomon, Roger
AU  - Salomon R
FAU - de Sousa, Alexandra
AU  - de Sousa A
FAU - Doumbo, Ogobara K
AU  - Doumbo OK
LA  - eng
SI  - ClinicalTrials.gov/NCT00766662
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20110718
PL  - England
TA  - BMC Public Health
JT  - BMC public health
JID - 100968562
RN  - 0 (Antimalarials)
RN  - 0 (Drug Combinations)
RN  - 0 (Vaccines)
RN  - 37338-39-9 (fanasil, pyrimethamine drug combination)
RN  - 88463U4SM5 (Sulfadoxine)
RN  - Z3614QOX8W (Pyrimethamine)
SB  - IM
MH  - Antimalarials/administration & dosage/*therapeutic use
MH  - Cluster Analysis
MH  - Cross-Sectional Studies
MH  - Drug Combinations
MH  - Female
MH  - Humans
MH  - Immunization Programs/*organization & administration
MH  - Infant
MH  - Malaria/*prevention & control
MH  - Male
MH  - Mali
MH  - Pyrimethamine/administration & dosage/*therapeutic use
MH  - Sulfadoxine/administration & dosage/*therapeutic use
MH  - Vaccines/administration & dosage
PMC - PMC3155918
EDAT- 2011/07/20 06:00
MHDA- 2011/12/14 06:00
PMCR- 2011/07/18
CRDT- 2011/07/20 06:00
PHST- 2010/06/30 00:00 [received]
PHST- 2011/07/18 00:00 [accepted]
PHST- 2011/07/20 06:00 [entrez]
PHST- 2011/07/20 06:00 [pubmed]
PHST- 2011/12/14 06:00 [medline]
PHST- 2011/07/18 00:00 [pmc-release]
AID - 1471-2458-11-573 [pii]
AID - 10.1186/1471-2458-11-573 [doi]
PST - epublish
SO  - BMC Public Health. 2011 Jul 18;11:573. doi: 10.1186/1471-2458-11-573.