Studies Assess Intermittent Preventive Malaria Treatment

Researchers see benefits of sulfadoxine-pyrimethamine, mefloquine in infants
By Eric Metcalf
HealthDay Reporter

THURSDAY, Sept. 17 (HealthDay News) -- Intermittent preventive treatment in infants (IPTi) against malaria using sulfadoxine-pyrimethamine may be beneficial in a range of malaria-transmission settings, and IPTi with mefloquine may help protect infants from malaria in moderate-transmission areas, according to research from two studies set in Africa published online Sept. 17 in The Lancet.

John J. Aponte, M.D., of the University of Barcelona in Spain, and colleagues conducted a pooled analysis of six randomized trials involving 7,930 infants that evaluated the efficacy of IPTi with sulfadoxine-pyrimethamine compared to placebo in Tanzania, Mozambique, Gabon and Ghana. They found that IPTi had a protective efficacy of 30.3 percent against clinical malaria and 38.1 percent against hospital admissions linked to malaria parasitemia. The risk of anemia was also lower in infants in the IPTi group.

Roly D. Gosling, M.D., of the London School of Hygiene and Tropical Medicine, and colleagues analyzed data from 2,419 Tanzanian infants, ages 8 to 16 weeks, in low- and moderate-intensity malaria transmission regions in an area with high resistance to sulfadoxine-pyrimethamine. Infants were randomized to receive placebo, sulfadoxine-pyrimethamine, chlorproguanil-dapsone, or mefloquine at several immunizations. At the moderate-transmission location, only mefloquine substantially reduced malaria incidence in infants ages 2 to 11 months, but was not well tolerated.

"We need to evaluate the newly introduced antimalarials (piperaquine and pyronaridine look promising) as well as mefloquine to assess whether, and when is the best time, to give IPT," writes the author of an accompanying commentary.

GlaxoSmithKline and Roche provided medications for the second study.

Abstract - Aponte
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Abstract - Gosling
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Commentary (subscription or payment may be required)

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