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Randomized Controlled Trial
. 2010 May;82(5):772-81.
doi: 10.4269/ajtmh.2010.09-0207.

Community effectiveness of intermittent preventive treatment for infants (IPTi) in rural southern Tanzania

Joanna R M Armstrong Schellenberg  1 , Kizito Shirima, Werner Maokola, Fatuma Manzi, Mwifadhi Mrisho, Adiel Mushi, Hassan Mshinda, Pedro Alonso, Marcel Tanner, David M Schellenberg
Affiliations
Randomized Controlled Trial

Community effectiveness of intermittent preventive treatment for infants (IPTi) in rural southern Tanzania

Joanna R M Armstrong Schellenberg et al. Am J Trop Med Hyg. 2010 May.

Abstract

Intermittent preventive treatment of malaria in infants (IPTi) with sulphadoxine-pyrimethamine shows evidence of efficacy in individually randomized, controlled trials. In a large-scale effectiveness study, IPTi was introduced in April 2005 by existing health staff through routine contacts in 12 randomly selected divisions out of 24 in 6 districts of rural southern Tanzania. Coverage and effects on malaria and anemia were estimated through a representative survey in 2006 with 600 children aged 2-11 months. Coverage of IPTi was 47-76% depending on the definition. Using an intention to treat analysis, parasitemia prevalence was 31% in intervention and 38% in comparison areas (P = 0.06). In a "per protocol" analysis of children who had recently received IPTi, parasite prevalence was 22%, 19 percentage points lower than comparison children (P = 0.01). IPTi can be implemented on a large scale by existing health service staff, with a measurable population effect on malaria, within 1 year of launch.

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Figures

Figure 1.
Figure 1.
Map of the study area, showing divisions randomized to receive IPTi (shaded).
Figure 2.
Figure 2.
Trial profile.
Figure 3.
Figure 3.
Malaria parasitemia (antigenemia) by age in months in children from IPTi and comparison areas, 2006 household survey, using intention-to-treat analysis.
Figure 4.
Figure 4.
Hemoglobin levels by age in months in children from IPTi and comparison areas, 2006 household survey, using intention-to-treat analysis.
See this image and copyright information in PMC

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