Preventing malaria in infants

A pooled analysis of clinical trials conducted in Africa on the safety and efficacy of sulphadoxine-pyrimethamine administered as an intermittent preventive treatment in infants (IPTi) for malaria control has revealed positive results.

IPTi is the administration of a full course of a drug at specified time points, whether or not the parasite is present.

In the double-blind, randomized trials, which were conducted at six sites in Tanzania, Mozambique, Gabon and Ghana, the treatment was administered to infants concurrently with routine vaccination. IPTi showed a 30.3% increase in protection against clinical malaria, and a 38.1% decrease in hospital admissions related to the malaria parasite. The analysis also showed a 21.3% decrease in the risk of anaemia.

Although the analysis did not show a difference in death rates between the test and control groups, the reduced incidence of illness in the former suggests that IPTi might save lives in the long term, especially in poorer communities with more limited curative and protective knowledge.

However, as the analysts point out, parasitic resistance to sulphadoxine-pyrimethamine is quickly spreading across Africa. This could undermine the efficacy of treatment options such as IPTi. Moreover, there is evidence that IPTi might hinder the development of naturally acquired immunity to malaria.

IPTi is already being used in seven African countries. Along with the results from the pooled analysis, this suggests that IPTi can play an important role in reducing the burden of malaria in infants along with other effective control methods.

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