Morbidity from Malaria in Children in the Year after They Had Received Intermittent Preventive Treatment of Malaria: A Randomised Trial

Autor: Amidou Diarra, Amidou Ouedraogo, David T. Kangoye, Adama Gansané, Issiaka Soulama, Sodiomon B. Sirima, Alfred B. Tiono, Youssouf Kaboré, Daniel Chandramohan, Amadou T. Konaté, Espérance Ouédraogo, Alphonse Ouedraogo, Issa Ouedraogo, Diadier Diallo, Brian Greenwood, Jean Baptiste Yaro, Paul Milligan, Simon Cousens
Rok vydání: 2011
Předmět:
Male
Travel-Associated Diseases
Pediatrics
Epidemiology
medicine.medical_treatment
lcsh:Medicine
Kaplan-Meier Estimate
Mosquitoes
Prevalence
Malaria
Falciparum
lcsh:Science
Wasting
Mosquito Nets
Multidisciplinary
biology
Incidence
Incidence (epidemiology)
Child Health
Anemia
Drug Combinations
Infectious Diseases
Pyrimethamine
Treatment Outcome
Child
Preschool
Medicine
Drug Therapy
Combination
Female
Public Health
Seasons
medicine.symptom
Research Article
medicine.drug
Drugs and Devices
medicine.medical_specialty
Drug Research and Development
Infectious Disease Control
Clinical Research Design
Sulfadoxine
Plasmodium falciparum
Amodiaquine
Drug Administration Schedule
Antimalarials
Double-Blind Method
Burkina Faso
parasitic diseases
Parasitic Diseases
medicine
Humans
Clinical Trials
business.industry
Body Weight
lcsh:R
Tropical Diseases (Non-Neglected)
Infant
Vectors and Hosts
biology.organism_classification
medicine.disease
Malaria
Malnutrition
lcsh:Q
Preventive Medicine
Morbidity
business
Follow-Up Studies
Zdroj: PLoS ONE, Vol 6, Iss 8, p e23391 (2011)
PLoS ONE
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0023391
Popis: BACKGROUND: Interventions that reduce exposure to malaria infection may lead to delayed malaria morbidity and mortality. We investigated whether intermittent preventive treatment of malaria in children (IPTc) was associated with an increase in the incidence of malaria after cessation of the intervention. METHODS: An individually randomised, trial of IPTc, comparing three courses of sulphadoxine pyrimethamine (SP) plus amodiaquine (AQ) with placebos was implemented in children aged 3-59 months during the 2008 malaria transmission season in Burkina Faso. All children in the trial were given a long lasting insecticide treated net; 1509 children received SP+AQ and 1505 received placebos. Passive surveillance for malaria was maintained until the end of the subsequent malaria transmission season in 2009, and active surveillance for malaria infection, anaemia and malnutrition was conducted. RESULTS: On thousand, four hundred and sixteen children (93.8%) and 1399 children (93.0%) initially enrolled in the intervention and control arms of the trial respectively were followed during the 2009 malaria transmission season. During the period July 2009 to November 2009, incidence rates of clinical malaria were 3.84 (95%CI; 3.67-4.02) and 3.45 (95%CI; 3.29-3.62) episodes per child during the follow up period in children who had previously received IPT or placebos, indicating a small increase in risk for children in the former intervention arm (IRR = 1.12; 95%CI 1.04-1.20) (P = 0.003). Children who had received SP+AQ had a lower prevalence of malaria infection (adjusted PR: 0.88 95%CI: 0.79-0.98) (P = 0.04) but they had a higher parasite density (P = 0.001) if they were infected. There was no evidence that the risks of moderately severe anaemia (Hb
Databáze: OpenAIRE
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