Implementation and effectiveness of intermittent preventive treatment in school aged children using dihydroartemisinin-piperaquine to reduce malaria burden: an implementation research of a cluster randomised trial in Tanzania
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View abstract on PubMed
Summary
This summary is machine-generated.Intermittent preventive treatment of malaria in schoolchildren (IPTsc) using Dihydroartemisinin-Piperaquine (DP) significantly reduced malaria incidence and parasite prevalence in Tanzania. This school-based approach proved feasible and effective, paving the way for national policy adoption.
Area Of Science
- Global Health
- Infectious Diseases
- Parasitology
Background
- Malaria significantly impacts school-aged children in endemic areas, causing mortality and affecting cognitive development.
- Asymptomatic malaria infections are common in this age group, contributing to health issues and reduced school performance.
- Existing malaria control programs often overlook school-aged children due to low adherence to interventions.
Purpose Of The Study
- To evaluate the pilot implementation of intermittent preventive treatment of malaria in schoolchildren (IPTsc) using Dihydroartemisinin-Piperaquine (DP).
- To assess the feasibility and effectiveness of IPTsc delivered by schoolteachers in a high malaria endemic area in Tanzania.
- To determine the impact of IPTsc on asymptomatic and clinical malaria in schoolchildren.
Main Methods
- A cluster-randomised design was employed, with wards assigned to either IPTsc or control arms.
- Schoolchildren in the intervention arm received three annual rounds of DP treatment.
- Primary endpoints included IPTsc coverage, clinical malaria incidence, and parasite prevalence, analyzed using cluster-adjusted intention-to-treat methods.
Main Results
- IPTsc achieved high coverage rates (73-80%) across three annual rounds, with Dihydroartemisinin-Piperaquine (DP) being well-tolerated.
- Clinical malaria incidence was reduced by 41% overall and 54% in high endemic areas.
- Parasite prevalence decreased significantly by 81% overall, with a notable 83% reduction in high endemic strata.
Conclusions
- Large-scale implementation of IPTsc demonstrated operational feasibility and community acceptance, comparable to findings in randomized trials.
- The study provides a benchmark for school-based malaria chemoprevention in Tanzania.
- The results support the groundwork for national policy adoption of IPTsc for malaria control in schoolchildren.
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