Morbidity from malaria in children in the year after they had received intermittent preventive treatment of malaria: a randomised trial.

<h4>Background</h4>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 cessat...

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Main Authors: Amadou T Konaté, Jean Baptiste Yaro, Amidou Z Ouédraogo, Amidou Diarra, Adama Gansané, Issiaka Soulama, David T Kangoyé, Youssouf Kaboré, Espérance Ouédraogo, Alphonse Ouédraogo, Alfred B Tiono, Issa N Ouédraogo, Daniel Chandramohan, Simon Cousens, Paul J Milligan, Sodiomon B Sirima, Brian M Greenwood, Diadier A Diallo
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2011-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0023391&type=printable
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author Amadou T Konaté
Jean Baptiste Yaro
Amidou Z Ouédraogo
Amidou Diarra
Adama Gansané
Issiaka Soulama
David T Kangoyé
Youssouf Kaboré
Espérance Ouédraogo
Alphonse Ouédraogo
Alfred B Tiono
Issa N Ouédraogo
Daniel Chandramohan
Simon Cousens
Paul J Milligan
Sodiomon B Sirima
Brian M Greenwood
Diadier A Diallo
author_facet Amadou T Konaté
Jean Baptiste Yaro
Amidou Z Ouédraogo
Amidou Diarra
Adama Gansané
Issiaka Soulama
David T Kangoyé
Youssouf Kaboré
Espérance Ouédraogo
Alphonse Ouédraogo
Alfred B Tiono
Issa N Ouédraogo
Daniel Chandramohan
Simon Cousens
Paul J Milligan
Sodiomon B Sirima
Brian M Greenwood
Diadier A Diallo
author_sort Amadou T Konaté
collection DOAJ
description <h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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<8 g/dL), wasting, stunting, or of being underweight in children differed between treatment arms.<h4>Conclusion</h4>IPT with SP+AQ was associated with a small increase in the incidence of clinical malaria in the subsequent malaria transmission season.<h4>Trial registration</h4>ClinicalTrials.gov NCT00738946.
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spelling doaj-art-9215a7d42d3b4c8b873903bd9a0abb7d2025-08-20T03:09:48ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-01-0168e2339110.1371/journal.pone.0023391Morbidity from malaria in children in the year after they had received intermittent preventive treatment of malaria: a randomised trial.Amadou T KonatéJean Baptiste YaroAmidou Z OuédraogoAmidou DiarraAdama GansanéIssiaka SoulamaDavid T KangoyéYoussouf KaboréEspérance OuédraogoAlphonse OuédraogoAlfred B TionoIssa N OuédraogoDaniel ChandramohanSimon CousensPaul J MilliganSodiomon B SirimaBrian M GreenwoodDiadier A Diallo<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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<8 g/dL), wasting, stunting, or of being underweight in children differed between treatment arms.<h4>Conclusion</h4>IPT with SP+AQ was associated with a small increase in the incidence of clinical malaria in the subsequent malaria transmission season.<h4>Trial registration</h4>ClinicalTrials.gov NCT00738946.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0023391&type=printable
spellingShingle Amadou T Konaté
Jean Baptiste Yaro
Amidou Z Ouédraogo
Amidou Diarra
Adama Gansané
Issiaka Soulama
David T Kangoyé
Youssouf Kaboré
Espérance Ouédraogo
Alphonse Ouédraogo
Alfred B Tiono
Issa N Ouédraogo
Daniel Chandramohan
Simon Cousens
Paul J Milligan
Sodiomon B Sirima
Brian M Greenwood
Diadier A Diallo
Morbidity from malaria in children in the year after they had received intermittent preventive treatment of malaria: a randomised trial.
PLoS ONE
title Morbidity from malaria in children in the year after they had received intermittent preventive treatment of malaria: a randomised trial.
title_full Morbidity from malaria in children in the year after they had received intermittent preventive treatment of malaria: a randomised trial.
title_fullStr Morbidity from malaria in children in the year after they had received intermittent preventive treatment of malaria: a randomised trial.
title_full_unstemmed Morbidity from malaria in children in the year after they had received intermittent preventive treatment of malaria: a randomised trial.
title_short Morbidity from malaria in children in the year after they had received intermittent preventive treatment of malaria: a randomised trial.
title_sort morbidity from malaria in children in the year after they had received intermittent preventive treatment of malaria a randomised trial
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0023391&type=printable
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