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Intermittent preventive therapy for malaria: progress and future directions.

Martin P Grobusch¹, Andrea Egan, Roly D Gosling

¹Infectious Diseases Unit, Division of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service and University of Witwatersrand, Johannesburg, South Africa. martin.grobusch@wits.ac.za

Current Opinion in Infectious Diseases

|November 3, 2007

Summary

Intermittent preventive treatment in infancy (IPTi) with sulfadoxine-pyrimethamine significantly reduces malaria and hospital admissions in infants. This safe, inexpensive intervention is a valuable tool for malaria control in Africa.

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Area of Science:

Global Health
Tropical Medicine
Pediatric Infectious Diseases

Background:

Malaria remains a significant public health challenge, particularly in infants in endemic regions.
Intermittent preventive treatment strategies aim to reduce malaria burden through scheduled drug administration.

Purpose of the Study:

To review current evidence on the efficacy of intermittent preventive treatment in infancy (IPTi).
To examine the rationale and effectiveness of IPTi as a malaria control strategy.

Main Methods:

Pooled safety and efficacy analyses of six IPTi trials using sulfadoxine-pyrimethamine (1999-2007).
Evaluation of clinical malaria, hospital admissions, and anemia in infants.

Main Results:

IPTi demonstrated 30% efficacy against clinical malaria in the first year of life.
Significant reductions observed in all-cause (24%) and malaria-related (37%) hospital admissions.
A 15% protective efficacy against anemia was noted, with no malaria rebound after discontinuation.

Conclusions:

IPTi-sulfadoxine-pyrimethamine is an effective, safe, and cost-effective tool for malaria control in African infants.
Integration with the Expanded Programme on Immunization enhances delivery.
Ongoing monitoring and potential adaptations for seasonal malaria are recommended.