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J Infect Dis. 2016 Jan 15;213(2):266-75. doi: 10.1093/infdis/jiv382. Epub 2015 Jul 13.

Effect of Repeated Anthelminthic Treatment on Malaria in School Children in Kenya: A Randomized, Open-Label, Equivalence Trial.

Author information

1
School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
2
London School of Hygiene and Tropical Medicine, United Kingdom.
3
Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute (KEMRI).
4
Neglected Tropical Diseases Research Unit, Center for Global Health Research, KEMRI, Kisumu, Kenya.
5
London School of Hygiene and Tropical Medicine, United Kingdom KEMRI-Wellcome Trust Research Programme, Nairobi.

Abstract

BACKGROUND:

School children living in the tropics are often concurrently infected with plasmodium and helminth parasites. It has been hypothesized that immune responses evoked by helminths may modify malaria-specific immune responses and increase the risk of malaria.

METHODS:

We performed a randomized, open-label, equivalence trial among 2436 school children in western Kenya. Eligible children were randomized to receive either 4 repeated doses or a single dose of albendazole and were followed up during 13 months to assess the incidence of clinical malaria. Secondary outcomes were Plasmodium prevalence and density, assessed by repeat cross-sectional surveys over 15 months. Analysis was conducted on an intention-to-treat basis with a prespecified equivalence range of 20%.

RESULTS:

During 13 months of follow-up, the incidence rate of malaria was 0.27 episodes/person-year in the repeated treatment group and 0.26 episodes/person-year in the annual treatment group (incidence difference, 0.01; 95% confidence interval, -.03 to .06). The prevalence and density of malaria parasitemia did not differ by treatment group at any of the cross-sectional surveys.

CONCLUSIONS:

Our findings suggest that repeated deworming does not alter risks of clinical malaria or malaria parasitemia among school children and that school-based deworming in Africa may have no adverse consequences for malaria.

CLINICAL TRIALS REGISTRATION:

NCT01658774.

KEYWORDS:

Kenya; deworming; helminths; malaria; school children

PMID:
26170395
PMCID:
PMC4690148
DOI:
10.1093/infdis/jiv382
[Indexed for MEDLINE]
Free PMC Article

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