Duration of Protection Against Clinical Malaria Provided by three Regimens of Intermittent Preventive Treatment in Tanzanian Infants
| العنوان: | Duration of Protection Against Clinical Malaria Provided by three Regimens of Intermittent Preventive Treatment in Tanzanian Infants |
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| المؤلفون: | Harparkash Kaur, Matthew Cairns, Ilona Carneiro, Roly Gosling, Martha M. Lemnge, Ramadhan Hashim, Daniel Chandramohan, Brian Greenwood, Frank W. Mosha, Jacklin F. Mosha, Samwel Gesase |
| المصدر: | PLoS ONE, Vol 5, Iss 3, p e9467 (2010) PLoS ONE |
| بيانات النشر: | Public Library of Science, 2010. |
| سنة النشر: | 2010 |
| مصطلحات موضوعية: | Pediatrics, Time Factors, medicine.medical_treatment, Drug Resistance, lcsh:Medicine, Pharmacology, Tanzania, Placebos, lcsh:Science, Diagnosis & treatment, education.field_of_study, Multidisciplinary, Mefloquine, Drug Combinations, Pyrimethamine, Treatment Outcome, Infectious Diseases, Tolerability, Proguanil, Research Design, Chemoprophylaxis, medicine.drug, Research Article, Infectious Diseases/Tropical and Travel-Associated Diseases, Infectious Diseases/Epidemiology and Control of Infectious Diseases, medicine.medical_specialty, Sulfadoxine, Population, Drug Administration Schedule, Antimalarials, parasitic diseases, medicine, Humans, education, Immunization Schedule, Infectious Diseases/Antimicrobials and Drug Resistance, business.industry, lcsh:R, Infant, Newborn, Infectious Diseases/Protozoal Infections, Infant, medicine.disease, Malaria, lcsh:Q, business, Dapsone |
| الوصف: | BACKGROUND: Intermittent preventive treatment in infants (IPTi) is a new malaria control tool. However, it is uncertain whether IPTi works mainly through chemoprophylaxis or treatment of existing infections. Understanding the mechanism is essential for development of replacements for sulfadoxine-pyrimethamine (SP) where it is no longer effective. This study investigated how protection against malaria given by SP, chlorproguanil-dapsone (CD) and mefloquine (MQ), varied with time since administration of IPTi. METHODS AND FINDINGS: A secondary analysis of data from a randomised, placebo-controlled trial in an area of high antifolate resistance in Tanzania was conducted. IPTi using SP, CD, MQ or placebo was given to 1280 infants at 2, 3 and 9 months of age. Poisson regression with random effects to adjust for potential clustering of malaria episodes within children was used to calculate incidence rate ratios for clinical malaria in defined time strata following IPTi. The short-acting antimalarial CD gave no protection against clinical malaria, whereas long-acting MQ gave two months of substantial protection (protective efficacy (PE) 73.1% (95% CI: 23.9, 90.5) and 73.3% (95% CI: 0, 92.9) in the first and second month respectively). SP gave some protection in the first month after treatment (PE 64.5% (95% CI: 10.6, 85.9)) although it did not reduce the incidence of malaria up to 12 months of age. There was no evidence of either long-term protection or increased risk of malaria for any of the regimens. CONCLUSION: Post-treatment chemoprophylaxis appears to be the main mechanism by which IPTi protects children against malaria. Long-acting antimalarials are therefore likely to be the most effective drugs for IPTi, but as monotherapies could be vulnerable to development of drug resistance. Due to concerns about tolerability, the mefloquine formulation used in this study is not suitable for IPTi. Further investigation of combinations of long-acting antimalarials for IPTi is needed. TRIAL REGISTRATION: Clinicaltrials.gov NCT00158574. |
| وصف الملف: | application/pdf |
| تدمد: | 1932-6203 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::8740ce751afb8c082cb8463ba1b00405 http://digitallibrary.ihi.or.tz/2031/ |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....8740ce751afb8c082cb8463ba1b00405 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19326203 |
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