Treatment of Asymptomatic Carriers of Plasmodium falciparum with Artemether–Lumefantrine: Impact on the Prevalence of Anemia

INTRODUCTION: An investigation of whether treatment of asymptomatic carriers of Plasmodium falciparum with artemether–lumefantrine (AL), in addition to the routine treatment of symptomatic cases with AL, could improve the prevalence of anemia in 18 villages in Burkina Faso. METHODS: This was a single-center, controlled, parallel, cluster-randomized study to evaluate the effect of systematic treatment of P. falciparum asymptomatic carriers at a community level on hemoglobin (Hb) levels and anemic status of children (<5 years) and adults during four screening campaigns carried out over a 12-month period, compared with no treatment of asymptomatic carriers. RESULTS: The change in Hb level in all asymptomatic carriers aged >6 months from Day 1 to Day 28 of the first campaign was +0.53 g/dl (from 11.81 to 12.33 g/dl) in the intervention arm vs. −0.21 g/dl (from 12.06 to 11.86 g/dl) in the control arm (P < 0.001). During the same period, the proportion of asymptomatic carriers aged >6 months to <5 years with anemia in the intervention arm decreased by 31.1% (from 75.7% to 44.6%), compared with a decrease of 4.7% (from 76.3% to 71.6%) in the control arm. Over 12 months, the proportion of asymptomatic carriers with anemia (mild, moderate, or severe) was reduced in both arms. CONCLUSION: Systematic screening and treatment of asymptomatic carriers of P. falciparum with AL at the community level can reduce the prevalence of anemia in children in the short term (28 days), although the effect was not maintained at 12 months.