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London School of Hygiene & Tropical Medicine Malaria Centre

Malaria research in epidemiology

Intermittent Preventive Treatment (IPT) for African Children: where and how should IPT be applied?

LSHTM investigators:
Ilona Carneiro, Arantxa Roca-Feltrer, Lucy Smith, Joanna Armstrong- Schellenberg, Brian Greenwood & David Schellenberg.
External collaborators:
Tom Smith, Marcel Tanner & Amanda Ross (Swiss Tropical and Public Health Institute, Switzerland).
Funding body:
The Bill & Melinda Gates Foundation and the UK Department for International Development.

Intermittent Preventive Treatment in infants (IPTi) is the administration of a therapeutic dose of an antimalarial drug at the time of selected routine vaccinations through the Expanded Programme on Immunization.

In 2010 IPTi with sulphadoxine-pyramethamine (SP) was recommended by the WHO for use “in areas of moderate to high malaria transmission” and “where parasite resistance to SP is not high”. 

Data on the age patterns of clinical cases of Plasmodium falciparum malaria, hospital admission with malaria parasites and malaria-associated death were used to estimate the percentage of cases of these outcomes that would occur in children aged < 10 years under different transmission intensity and seasonality of malaria. A similar analysis of severe malaria syndromes was also undertaken. A stochastic mathematical model of IPTi was used to predict the number of cases likely to be averted by implementing IPTi.

These results were combined into an internet-based decision-support tool to help policy-makers assess whether IPTi would be effective for local malaria control.

The web-tool has been updated to enable variation in IPTi schedule and coverage, health systems costs, and local levels of SP drug-resistance. It is freely accessible on the LSHTM website..