Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi)
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Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi). / Kobbe, Robin; Adjei, Samuel; Kreuzberg, Christina; Kreuels, Benno; Thompson, Benedicta; Thompson, Peter A; Marks, Florian; Busch, Wibke; Tosun, Meral; Schreiber, Nadine; Opoku, Ernest; Adjei, Ohene; Meyer, Christian G; May, Juergen.
In: MALARIA J, Vol. 6, 01.01.2007, p. 163.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Malaria incidence and efficacy of intermittent preventive treatment in infants (IPTi)
AU - Kobbe, Robin
AU - Adjei, Samuel
AU - Kreuzberg, Christina
AU - Kreuels, Benno
AU - Thompson, Benedicta
AU - Thompson, Peter A
AU - Marks, Florian
AU - Busch, Wibke
AU - Tosun, Meral
AU - Schreiber, Nadine
AU - Opoku, Ernest
AU - Adjei, Ohene
AU - Meyer, Christian G
AU - May, Juergen
PY - 2007/1/1
Y1 - 2007/1/1
N2 - BACKGROUND: Intermittent preventive antimalarial treatment in infants (IPTi) is currently evaluated as a malaria control strategy. Among the factors influencing the extent of protection that is provided by IPTi are the transmission intensity, seasonality, drug resistance patterns, and the schedule of IPTi administrations. The aim of this study was to determine how far the protective efficacy of IPTi depends on spatio-temporal variations of the prevailing incidence of malaria.METHODS: One thousand seventy infants were enrolled in a registered controlled trial on the efficacy of IPTi with sulphadoxine-pyrimethamine (SP) in the Ashanti Region, Ghana, West Africa (ClinicalTrial.gov: NCT00206739). Stratification for the village of residence and the month of birth of study participants demonstrated that the malaria incidence was dependent on spatial (range of incidence rates in different villages 0.6-2.0 episodes/year) and temporal (range of incidence rates in children of different birth months 0.8-1.2 episodes/year) factors. The range of spatio-temporal variation allowed ecological analyses of the correlation between malaria incidence rates, anti-Plasmodium falciparum lysate IgG antibody levels and protective efficacies provided by IPTi.RESULTS: Protective efficacy of the first SP administration was positively correlated with malaria incidences in children living in a distinct village or born in a distinct month (R2 0.48, p < 0.04 and R2 0.63, p < 0.003, respectively). Corresponding trends were seen after the second and third study drug administration. Accordingly, IgG levels against parasite lysate increased with malaria incidence. This correlation was stronger in children who received IPTi, indicating an effect modification of the intervention.CONCLUSION: The spatial and temporal variations of malaria incidences in a geographically and meteorologically homogeneous study area exemplify the need for close monitoring of local incidence rates in all types of intervention studies. The increase of the protective efficacy of IPTi with malaria incidences may be relevant for IPTi implementation strategies and, possibly, for other malaria control measures.
AB - BACKGROUND: Intermittent preventive antimalarial treatment in infants (IPTi) is currently evaluated as a malaria control strategy. Among the factors influencing the extent of protection that is provided by IPTi are the transmission intensity, seasonality, drug resistance patterns, and the schedule of IPTi administrations. The aim of this study was to determine how far the protective efficacy of IPTi depends on spatio-temporal variations of the prevailing incidence of malaria.METHODS: One thousand seventy infants were enrolled in a registered controlled trial on the efficacy of IPTi with sulphadoxine-pyrimethamine (SP) in the Ashanti Region, Ghana, West Africa (ClinicalTrial.gov: NCT00206739). Stratification for the village of residence and the month of birth of study participants demonstrated that the malaria incidence was dependent on spatial (range of incidence rates in different villages 0.6-2.0 episodes/year) and temporal (range of incidence rates in children of different birth months 0.8-1.2 episodes/year) factors. The range of spatio-temporal variation allowed ecological analyses of the correlation between malaria incidence rates, anti-Plasmodium falciparum lysate IgG antibody levels and protective efficacies provided by IPTi.RESULTS: Protective efficacy of the first SP administration was positively correlated with malaria incidences in children living in a distinct village or born in a distinct month (R2 0.48, p < 0.04 and R2 0.63, p < 0.003, respectively). Corresponding trends were seen after the second and third study drug administration. Accordingly, IgG levels against parasite lysate increased with malaria incidence. This correlation was stronger in children who received IPTi, indicating an effect modification of the intervention.CONCLUSION: The spatial and temporal variations of malaria incidences in a geographically and meteorologically homogeneous study area exemplify the need for close monitoring of local incidence rates in all types of intervention studies. The increase of the protective efficacy of IPTi with malaria incidences may be relevant for IPTi implementation strategies and, possibly, for other malaria control measures.
KW - Animals
KW - Antimalarials
KW - Drug Combinations
KW - Drug Resistance
KW - Humans
KW - Infant
KW - Malaria, Falciparum
KW - Plasmodium falciparum
KW - Pyrimethamine
KW - Sulfadoxine
KW - Treatment Outcome
U2 - 10.1186/1475-2875-6-163
DO - 10.1186/1475-2875-6-163
M3 - SCORING: Journal article
C2 - 18067679
VL - 6
SP - 163
JO - MALARIA J
JF - MALARIA J
SN - 1475-2875
ER -