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Malar J. 2015 Nov 14;14:450. doi: 10.1186/s12936-015-0988-5.

Efficacy and safety of intermittent preventive treatment for malaria in schoolchildren: a systematic review.

Author information

1
Département de Médecine Tropicale, Faculté de Médecine, Université de Kinshasa, BP 747, Kinshasa, XI, Democratic Republic of the Congo. matangilaj@yahoo.fr.
2
Epidemiology for Global Health Institute, University of Antwerp, Campus DrieEiken, Universiteitsplein 1, Wilrijk, 2610, Belgium. matangilaj@yahoo.fr.
3
Département de Médecine Tropicale, Faculté de Médecine, Université de Kinshasa, BP 747, Kinshasa, XI, Democratic Republic of the Congo. pmitashi@yahoo.fr.
4
Epidemiology for Global Health Institute, University of Antwerp, Campus DrieEiken, Universiteitsplein 1, Wilrijk, 2610, Belgium. raquel.daluz@uantwerpen.be.
5
Département de Médecine Tropicale, Faculté de Médecine, Université de Kinshasa, BP 747, Kinshasa, XI, Democratic Republic of the Congo. pascal_lutumba@yahoo.fr.
6
Epidemiology for Global Health Institute, University of Antwerp, Campus DrieEiken, Universiteitsplein 1, Wilrijk, 2610, Belgium. Jean-Pierre.VanGeertruyden@uantwerpen.be.

Abstract

BACKGROUND:

Intermittent preventive treatment (IPT) is a proven malaria control strategy in infants and pregnancy. School-aged children represent 26 % of the African population, and an increasing percentage of them are scholarized. Malaria is causing 50 % of deaths in this age group and malaria control efforts may shift the malaria burden to older age groups. Schools have been suggested as a platform for health interventions delivery (deworming, iron-folic acid, nutrients supplementation, (boost-)immunization) and as a possible delivery system for IPT in schoolchildren (IPTsc). However, the current evidence on the efficacy and safety of IPTsc is limited and the optimal therapeutic regimen remains controversial.

METHODS:

A systematic search for studies reporting efficacy and safety of IPT in schoolchildren was conducted using PubMed, Web of Science, Clinicaltrials and WHO/ICTRP database, and abstracts from congresses with the following key words: intermittent, preventive treatment AND malaria OR Plasmodium falciparum AND schoolchildren NOT infant NOT pregnancy.

RESULTS:

Five studies were identified. Most IPTsc regimes demonstrated substantial protection against malaria parasitaemia, with dihydroartemisinin-piperaquine (DP) given monthly having the highest protective effect (PE) (94 %; 95 % CI 93-96). Contrarily, SP did not provide any PE against parasitaemia. However, no IPT regimen provided a PE above 50 % in regard to anaemia, and highest protection was provided by SP+ amodiaquine (AQ) given four-monthly (50 %; 95 % CI 41-53). The best protection against clinical malaria was observed in children monthly treated with DP (97 %; 95 % CI 87-98). However, there was no protection when the drug was given three-monthly. No severe adverse events were associated with the drugs used for IPTsc.

CONCLUSION:

IPTsc may reduce the malaria-related burden in schoolchildren. However, more studies assessing efficacy of IPT in particular against malaria-related anaemia and clinical malaria in schoolchildren must be conducted.

PMID:
26574017
PMCID:
PMC4647321
DOI:
10.1186/s12936-015-0988-5
[Indexed for MEDLINE]
Free PMC Article

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