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London School of Hygiene & Tropical Medicine Malaria Centre

Malaria research in epidemiology

Modelling the protective efficacy of alternative delivery schedules for Intermittent Preventive Treatment (IPT) of malaria in infants and children.

LSHTM investigators:
Matt Cairns, Roly Gosling, Ilona Carneiro, Paul Milligan, Brian Greenwood & Daniel Chandramohan.
External collaborators:
Lucy Okell & Azra Ghani (Imperial College London, UK); Francis Anto & Victor Asoala (Navrongo Health Research Centre, Ghana); Seth Owusu-Agyei (Kintampo Health Research Centre, Ghana).
Funding body:
Medical Research Council PhD studentship; Navrongo trial originally funded by the UK Department for International Development.

Intermittent preventive treatment for malaria in infants (IPTi) using sulphadoxine-pyrimethamine delivered alongside routine infant vaccinations is a recommended WHO policy.

To assist policy decisions made by WHO on the areas where this intervention would be appropriate, we have reviewed malaria incidence data and defined a surrogate predictor of seasonality in incidence based on rainfall.  Spatial rainfall, malaria endemicity and population data were then used to estimate the population and malaria burden in areas with highly seasonal malaria.  We estimate that in areas suitable for SMC, there are 39 million children under five years of age, 33.7 million child malaria episodes and 152,000 childhood deaths from malaria each year.  The majority of this burden occurs in the Sahelian or sub-Sahelian regions of Africa, where regimens currently available for SMC have been shown to be highly effective, safe and acceptable to communities.  SMC has the potential to avert several million malaria cases and tens of thousands of childhood deaths each year if successfully delivered to the populations at risk.