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Intermittent preventive treatment for malaria in infants
Ekpereonne B Esu1, Chioma Oringanje2, Martin M Meremikwu3
1College of Medical Sciences, University of Calabar, Department of Public Health, Calabar, Cross River State, Nigeria.
Intermittent preventive treatment for malaria in infants (IPTi) likely reduces clinical malaria, anemia, and hospital admissions in sub-Saharan Africa. Sulfadoxine-pyrimethamine (SP) efficacy declined over time, but artemisinin-based combination therapies (ACTs) show promise for IPTi.
Area of Science:
- Public Health
- Infectious Diseases
- Pediatrics
Background:
- Malaria remains a significant threat to infants in sub-Saharan Africa.
- Intermittent preventive treatment (IPT) is a strategy to combat malaria in infants (IPTi).
- WHO recommended IPTi in 2010, but adoption has been limited.
Purpose of the Study:
- To evaluate the effectiveness of IPT with antimalarial drugs for preventing malaria in infants.
- To assess the impact of IPTi on clinical malaria, anemia, parasitemia, and mortality.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Included 12 RCTs with 19,098 infants in sub-Saharan Africa.
- Searched multiple databases up to December 2018 for relevant trials.
Main Results:
- Overall, IPTi reduced clinical malaria by 27%.
- IPTi with sulfadoxine-pyrimethamine (SP) reduced malaria, anemia, and hospital admissions, but efficacy declined over time.
- Artemisinin-based combination therapies (ACTs) showed promising effects in recent trials.
Conclusions:
- IPTi is effective in reducing malaria incidence, anemia, and hospital admissions in infants.
- Declining SP efficacy necessitates exploring alternatives like ACTs for IPTi.
- ACTs show potential as effective alternatives for IPTi in malaria-endemic regions.
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