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London School of Hygiene & Tropical Medicine Malaria Centre

Malaria clinical trials and studies

The clinical impact of combining Intermittent Preventive Treatment (IPT) with home management of malaria in children aged below 5 years: a cluster randomised trial.

LSHTM investigators:
Harry Tagbor, Matt Cairns & Daniel Chandramohan.
External collaborators:
Emmanuel Nakwa, Edmund Browne (Kwame Nkrumah University of Science and Technology, Ghana); Badu Sarkodie (District Health Administration, Ghana); Helen Counihan & Sylvia Meek (Malaria Consortium, UK).
Funding body:
Communicable Diseases Research Consortium.

Seasonal intermittent preventive treatment in children (IPTc) has been shown to provide substantial reductions in malaria morbidity but this has not been investigated where children also have access to prompt treatment of malaria in their communities.

We investigated the additional impact of seasonal IPTc in Ghanaian communities using home-management of malaria for presumptive treatment of fevers in a cluster-randomised trial.  Bimonthly courses of seasonal IPTc with artesunate-amodiaquine reduced the incidence of fevers, particularly among children who received all three IPTc courses. Using IPTc to reducing the number of fevers that require management in the community could reduce selection pressure for resistance on the first-line treatment drug. However, high coverage will be necessary to maximise the impact of IPTc; community-based delivery may be one approach to achieving this goal.