Intermittent use of preventive malaria drugs in children found to help prevent malaria transmission, studies say

Three studies published on Tuesday in PLoS Medicine show that "intermittent use of preventive antimalarial drugs can be beneficial in curbing the spread of the disease in children," Agence France-Presse reports (2/1).

"Two randomized controlled trials (with over 3,000 children in each study) carried out by a team of researchers ... found that in the peak malarial transmission season in Burkina Faso and Mali, intermittent preventive treatment for malaria (using the antimalarial drugs sulphadoxine pyrimethamine and amodiaquine) provided substantial additional protection against episodes of clinical malaria, severe malaria, and all-cause hospital admissions in children sleeping under long-lasting insecticide treated bednets," a PLoS press release states. Intermittent preventive treatment "was initially recommended for pregnant women and has recently been extended to include infants and children," the release notes, adding that "previous studies in children were carried out in countries where the use of insecticide treated bednets ... was relatively low." As a result, the new findings "are important as they demonstrate the additional benefit that intermittent preventive treatment can confer on standard malaria control practice" (2/1).

In the Burkina Faso study, the researchers detected a 69 percent drop in the incidence of severe malaria and a 46 percent "reduction in the incidence of all-cause hospital admissions" (Konate et al., 2/1). "The authors of the Burkina Faso study wrote that the results offer 'strong evidence to support the integration of (intermittent preventive treatment for children) into malaria control strategies in areas of seasonal malaria transmission,'" AFP reports. In Mali, the study authors reached a similar conclusion: "These findings indicate that (the drugs) could make a valuable contribution to malaria control in areas of seasonal malaria transmission alongside other interventions" (2/1). The Mali authors found that intermittent preventive malaria treatment reduced the prevalence of malaria infection by 85 percent during the intervention period and by 46 percent at the end of the intervention period (Dicko et al., 2/1).  

"The research was led by Diadier Diallo from the London School of Hygiene & Tropical Medicine; Amadou Konate from the Centre National de Recherche et de Formation sur le Paludisme in Ouagadougou; and Alassane Dicko from the Malaria Research and Training Centre in Mali," according to AFP.

A third study, conducted in The Gambia, found that "administering the drugs by community-based, volunteer village health workers was more effective and less costly than delivery by reproductive and child health teams run by the Ministry of Health," the news service writes (2/1). In that study, the authors wrote: "Longer term experience will show whether the high level of coverage obtained in this study can be sustained but the results of this trial suggest that community volunteers can achieve high level coverage with this very effective malaria control intervention if they are supported to do so," according to the press release (2/1).

In a related perspective piece, also published in the journal, James Beeson of the Walter and Eliza Hall Institute of Medical Research and colleagues call for the implementation of intermittent preventive treatment of malaria in children (IPTc) "in specific settings to reduce the burden of malaria in children." The authors add: "However, there is still much we need to know about when, how, and under what circumstances to implement IPTc and how to mitigate the potential impact of increasing drug resistance and impairing immune acquisition. These questions need to be a high priority for ongoing research, not only for IPTc, but alongside other interventions in a multi-faceted approach to malaria control" (2/1).