Cargando…

Can changes in malaria transmission intensity explain prolonged protection and contribute to high protective efficacy of intermittent preventive treatment for malaria in infants?

BACKGROUND: Intermittent preventive (or presumptive) treatment of infants (IPTi), the administration of a curative anti-malarial dose to infants whether or not they are known to be infected, is being considered as a new strategy for malaria control. Five of the six trials using sulphadoxine-pyrimeth...

Descripción completa

Detalles Bibliográficos
Autores principales: Gosling, Roly D, Ghani, Azra C, Deen, Jaqueline L, von Seidlein, Lorenz, Greenwood, Brian M, Chandramohan, Daniel
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323384/
https://www.ncbi.nlm.nih.gov/pubmed/18387180
http://dx.doi.org/10.1186/1475-2875-7-54
_version_ 1782152645546344448
author Gosling, Roly D
Ghani, Azra C
Deen, Jaqueline L
von Seidlein, Lorenz
Greenwood, Brian M
Chandramohan, Daniel
author_facet Gosling, Roly D
Ghani, Azra C
Deen, Jaqueline L
von Seidlein, Lorenz
Greenwood, Brian M
Chandramohan, Daniel
author_sort Gosling, Roly D
collection PubMed
description BACKGROUND: Intermittent preventive (or presumptive) treatment of infants (IPTi), the administration of a curative anti-malarial dose to infants whether or not they are known to be infected, is being considered as a new strategy for malaria control. Five of the six trials using sulphadoxine-pyrimethamine (SP) for IPTi showed protective efficacies (PEs) against clinical malaria ranging from 20.1 – 33.3% whilst one, the Ifakara study, showed a protective efficacy of 58.6%. MATERIALS AND METHODS: The possible mechanisms that could explain the differences in the reported PE of IPTi were examined by comparing output from a mathematical model to data from the six published IPTi trials. RESULTS: Under stable transmission, the PE of IPTi predicted by the model was comparable with the observed PEs in all but the Ifakara study (ratio of the mean predicted PE to that observed was 1.02, range 0.39 – 1.59). When a reduction in the incidence of infection during the study was included in the model, the predicted PE of IPTi increased and extended into the second year of life, as observed in the Ifakara study. CONCLUSION: A decrease in malaria transmission during the study period may explain part of the difference in observed PEs of IPTi between sites and the extended period of protection into the second year of life observed in the Ifakara study. This finding of continued benefit of interventions in settings of decreasing transmission may explain why rebound of clinical malaria was absent in the large scale trials of insecticide-treated bed nets.
format Text
id pubmed-2323384
institution National Center for Biotechnology Information
language English
publishDate 2008
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-23233842008-04-21 Can changes in malaria transmission intensity explain prolonged protection and contribute to high protective efficacy of intermittent preventive treatment for malaria in infants? Gosling, Roly D Ghani, Azra C Deen, Jaqueline L von Seidlein, Lorenz Greenwood, Brian M Chandramohan, Daniel Malar J Research BACKGROUND: Intermittent preventive (or presumptive) treatment of infants (IPTi), the administration of a curative anti-malarial dose to infants whether or not they are known to be infected, is being considered as a new strategy for malaria control. Five of the six trials using sulphadoxine-pyrimethamine (SP) for IPTi showed protective efficacies (PEs) against clinical malaria ranging from 20.1 – 33.3% whilst one, the Ifakara study, showed a protective efficacy of 58.6%. MATERIALS AND METHODS: The possible mechanisms that could explain the differences in the reported PE of IPTi were examined by comparing output from a mathematical model to data from the six published IPTi trials. RESULTS: Under stable transmission, the PE of IPTi predicted by the model was comparable with the observed PEs in all but the Ifakara study (ratio of the mean predicted PE to that observed was 1.02, range 0.39 – 1.59). When a reduction in the incidence of infection during the study was included in the model, the predicted PE of IPTi increased and extended into the second year of life, as observed in the Ifakara study. CONCLUSION: A decrease in malaria transmission during the study period may explain part of the difference in observed PEs of IPTi between sites and the extended period of protection into the second year of life observed in the Ifakara study. This finding of continued benefit of interventions in settings of decreasing transmission may explain why rebound of clinical malaria was absent in the large scale trials of insecticide-treated bed nets. BioMed Central 2008-04-03 /pmc/articles/PMC2323384/ /pubmed/18387180 http://dx.doi.org/10.1186/1475-2875-7-54 Text en Copyright © 2008 Gosling et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Gosling, Roly D
Ghani, Azra C
Deen, Jaqueline L
von Seidlein, Lorenz
Greenwood, Brian M
Chandramohan, Daniel
Can changes in malaria transmission intensity explain prolonged protection and contribute to high protective efficacy of intermittent preventive treatment for malaria in infants?
title Can changes in malaria transmission intensity explain prolonged protection and contribute to high protective efficacy of intermittent preventive treatment for malaria in infants?
title_full Can changes in malaria transmission intensity explain prolonged protection and contribute to high protective efficacy of intermittent preventive treatment for malaria in infants?
title_fullStr Can changes in malaria transmission intensity explain prolonged protection and contribute to high protective efficacy of intermittent preventive treatment for malaria in infants?
title_full_unstemmed Can changes in malaria transmission intensity explain prolonged protection and contribute to high protective efficacy of intermittent preventive treatment for malaria in infants?
title_short Can changes in malaria transmission intensity explain prolonged protection and contribute to high protective efficacy of intermittent preventive treatment for malaria in infants?
title_sort can changes in malaria transmission intensity explain prolonged protection and contribute to high protective efficacy of intermittent preventive treatment for malaria in infants?
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2323384/
https://www.ncbi.nlm.nih.gov/pubmed/18387180
http://dx.doi.org/10.1186/1475-2875-7-54
work_keys_str_mv AT goslingrolyd canchangesinmalariatransmissionintensityexplainprolongedprotectionandcontributetohighprotectiveefficacyofintermittentpreventivetreatmentformalariaininfants
AT ghaniazrac canchangesinmalariatransmissionintensityexplainprolongedprotectionandcontributetohighprotectiveefficacyofintermittentpreventivetreatmentformalariaininfants
AT deenjaquelinel canchangesinmalariatransmissionintensityexplainprolongedprotectionandcontributetohighprotectiveefficacyofintermittentpreventivetreatmentformalariaininfants
AT vonseidleinlorenz canchangesinmalariatransmissionintensityexplainprolongedprotectionandcontributetohighprotectiveefficacyofintermittentpreventivetreatmentformalariaininfants
AT greenwoodbrianm canchangesinmalariatransmissionintensityexplainprolongedprotectionandcontributetohighprotectiveefficacyofintermittentpreventivetreatmentformalariaininfants
AT chandramohandaniel canchangesinmalariatransmissionintensityexplainprolongedprotectionandcontributetohighprotectiveefficacyofintermittentpreventivetreatmentformalariaininfants