Efficacy and safety of three regimens for the prevention of malaria in young HIV-exposed Ugandan children: a randomized controlled trial
| Autor: | Stephen Kinara, Tamara D. Clark, Philip J. Rosenthal, Francesca T. Aweeka, Diane V. Havlir, James Kapisi, Grant Dorsey, Florence Mwangwa, Liusheng Huang, Prasanna Jagannathan, Mary K. Muhindo, Jane Achan, Victor Bigira, Abel Kakuru, Moses R. Kamya |
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| Rok vydání: | 2014 |
| Předmět: |
Male
Pediatrics and promotion of well-being medicine.medical_treatment Breastfeeding Parasitemia Medical and Health Sciences Trimethoprim law.invention Cohort Studies Randomized controlled trial law Immunology and Allergy Uganda Child Pediatric Sulfamethoxazole Drug Combination Incidence (epidemiology) Biological Sciences Artemisinins Drug Combinations Pyrimethamine Treatment Outcome Infectious Diseases malaria chemoprevention Child Preschool 6.1 Pharmaceuticals Quinolines HIV/AIDS Female medicine.symptom Infection HIV-exposed uninfected infants Cohort study medicine.medical_specialty Sulfadoxine Immunology Clinical Trials and Supportive Activities dihydroartemsinin piperaquine Asymptomatic Chemoprevention Article Antimalarials Rare Diseases Clinical Research sulfadoxine pyrimethamine Virology parasitic diseases Trimethoprim Sulfamethoxazole Drug Combination medicine Humans Preschool 3.3 Nutrition and chemoprevention business.industry Prevention Psychology and Cognitive Sciences Infant Evaluation of treatments and therapeutic interventions medicine.disease Prevention of disease and conditions trimethoprim sulfamethoxazole prophylaxis Malaria Vector-Borne Diseases Good Health and Well Being 3.1 Primary prevention interventions to modify behaviours or promote wellbeing business |
| Zdroj: | AIDS (London, England), vol 28, iss 18 |
| Popis: | OBJECTIVE Trimethoprim-sulfamethoxazole prophylaxis is recommended for HIV-exposed infants until breastfeeding ends and HIV infection has been excluded. Extending prophylaxis with a focus on preventing malaria may be beneficial in high transmission areas. We investigated three regimens for the prevention of malaria in young HIV-exposed children. DESIGN An open-label, randomized controlled trial. SETTING Tororo, Uganda, a rural area with intense, year-round, malaria transmission. PARTICIPANTS Two hundred infants aged 4-5 months enrolled and 186 randomized after cessation of breastfeeding and confirmed to be HIV uninfected (median 10 months of age). INTERVENTION No chemoprevention, monthly sulfadoxine-pyrimethamine, daily trimethoprim-sulfamethoxazole or monthly dihydroartemisinin-piperaquine given from randomization to 24 months of age. MAIN OUTCOME MEASURES The primary outcome was the incidence of malaria during the intervention period. Secondary outcomes included the incidence of hospitalization, diarrhoeal illness, or respiratory tract infection; prevalence of anaemia and asymptomatic parasitemia; measures of safety; and incidence of malaria over 1 year after the intervention was stopped. RESULTS During the intervention, the incidence of malaria in the no chemoprevention group was 6.28 episodes per person-year at risk. Protective efficacy was 69% [95% confidence interval (95% CI) 53-80, P |
| Databáze: | OpenAIRE |
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