edoc

Efficacy and safety of intermittent preventive treatment with sulfadoxine-pyrimethamine for malaria in African infants : a pooled analysis of six randomised, placebo-controlled trials

Aponte, J. J. and Schellenberg, D. and Egan, A. and Breckenridge, A. and Carneiro, I. and Critchley, J. and Danquah, I. and Dodoo, A. and Kobbe, R. and Lell, B. and May, J. and Premji, Z. and Sanz, S. and Sevene, E. and Soulaymani-Becheikh R., and Winstanley, P. and Adjei, S. and Anemana, S. and Chandramohan, D. and Issifou, S. and Mockenhaupt, F. and Owusu-Agyei S., and Greenwood, B. and Grobusch, M. P. and Kremsner, P. G. and Macete, E. and Mshinda, H. and Newman, R. D. and Slutsker, L. and Tanner, M. and Alonso, P. and Menendez, C.. (2009) Efficacy and safety of intermittent preventive treatment with sulfadoxine-pyrimethamine for malaria in African infants : a pooled analysis of six randomised, placebo-controlled trials. Lancet, Vol. 374, no. 9700. S. 1533-1542.

Full text not available from this repository.

Official URL: http://edoc.unibas.ch/dok/A5843200

Downloads: Statistics Overview

Abstract

BACKGROUND: Intermittent preventive treatment (IPT) is a promising strategy for malaria control in infants. We undertook a pooled analysis of the safety and efficacy of IPT in infants (IPTi) with sulfadoxine-pyrimethamine in Africa. METHODS: We pooled data from six double-blind, randomised, placebo-controlled trials (undertaken one each in Tanzania, Mozambique, and Gabon, and three in Ghana) that assessed the efficacy of IPTi with sulfadoxine-pyrimethamine. In all trials, IPTi or placebo was given to infants at the time of routine vaccinations delivered by WHO's Expanded Program on Immunization. Data from the trials for incidence of clinical malaria, risk of anaemia (packed-cell volume >25% or haemoglobin >80 g/L), and incidence of hospital admissions and adverse events in infants up to 12 months of age were reanalysed by use of standard outcome definitions and time periods. Analysis was by modified intention to treat, including all infants who received at least one dose of IPTi or placebo. FINDINGS: The six trials provided data for 7930 infants (IPTi, n=3958; placebo, n=3972). IPTi had a protective efficacy of 30.3% (95% CI 19.8-39.4, p>0.0001) against clinical malaria, 21.3% (8.2-32.5, p=0.002) against the risk of anaemia, 38.1% (12.5-56.2, p=0.007) against hospital admissions associated with malaria parasitaemia, and 22.9% (10.0-34.0, p=0.001) against all-cause hospital admissions. There were 56 deaths in the IPTi group compared with 53 in the placebo group (rate ratio 1.05, 95% CI 0.72-1.54, p=0.79). One death, judged as possibly related to IPTi because it occurred 19 days after a treatment dose, was subsequently attributed to probable sepsis. Four of 676 non-fatal hospital admissions in the IPTi group were deemed related to study treatment compared with five of 860 in the placebo group. None of three serious dermatological adverse events in the IPTi group were judged related to study treatment compared with one of 13 in the placebo group. INTERPRETATION: IPTi with sulfadoxine-pyrimethamine was safe and efficacious across a range of malaria transmission settings, suggesting that this intervention is a useful contribution to malaria control. FUNDING: Bill & Melinda Gates Foundation.
Faculties and Departments:03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Malaria Vaccines (Tanner)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Former Units within Swiss TPH > Malaria Vaccines (Tanner)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Eco System Health Sciences > Health Impact Assessment (Utzinger)
UniBasel Contributors:Tanner, Marcel
Item Type:Article, refereed
Bibsysno:Link to catalogue
Publisher:The Lancet
ISSN:0140-6736
Note:Publication type according to Uni Basel Research Database: Journal article
Related URLs:
Identification Number:
Last Modified:05 Dec 2014 09:45
Deposited On:14 Sep 2012 06:46

Repository Staff Only: item control page