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. 2020 Sep 17;5(3):148.
doi: 10.3390/tropicalmed5030148.

Impact of Three-Year Intermittent Preventive Treatment Using Artemisinin-Based Combination Therapies on Malaria Morbidity in Malian Schoolchildren

Hamma Maiga  1   2   3 , Breanna Barger  4 , Issaka Sagara  2   3 , Abdoulaye Guindo  2   3 , Oumar B Traore  2   3 , Mamadou Tekete  2   3 , Antoine Dara  2   3 , Zoumana I Traore  2   3 , Modibo Diarra  2   3 , Samba Coumare  2   3 , Aly Kodio  2   3 , Ousmane B Toure  2   3 , Ogobara K Doumbo  2   3 , Abdoulaye A Djimde  2   3
Affiliations

Impact of Three-Year Intermittent Preventive Treatment Using Artemisinin-Based Combination Therapies on Malaria Morbidity in Malian Schoolchildren

Hamma Maiga et al. Trop Med Infect Dis. .

Abstract

Previous studies have shown that a single season of intermittent preventive treatment in schoolchildren (IPTsc) targeting the transmission season has reduced the rates of clinical malaria, all-cause clinic visits, asymptomatic parasitemia, and anemia. Efficacy over the course of multiple years of IPTsc has been scantly investigated.

Methods: An open, randomized-controlled trial among schoolchildren aged 6-13 years was conducted from September 2007 to January 2010 in Kolle, Mali. Students were included in three arms: sulphadoxine-pyrimethamine+artesunate (SP+AS), amodiaquine+artesunate (AQ+AS), and control (C). All students received two full doses, given 2 months apart, and were compared with respect to the incidence of clinical malaria, all-cause clinic visits, asymptomatic parasitemia, and anemia.

Results: A total of 296 students were randomized. All-cause clinic visits were in the SP+AS versus control (29 (20.1%) vs. 68 (47.2%); 20 (21.7%) vs. 41 (44.6%); and 14 (21.2%) vs. 30 (44.6%); p < 0.02) in 2007, 2008, and 2009, respectively. The prevalence of asymptomatic parasitemia was lower in the SP+AS compared to control (38 (7.5%) vs. 143 (28.7%); and 47 (12.7%) vs. 75 (21.2%); p < 0.002) in 2007 and 2008, respectively. Hemoglobin concentration was significantly higher in children receiving SP+AS (11.96, 12.06, and 12.62 g/dL) than in control children (11.60, 11.64, and 12.15 g/dL; p < 0.001) in 2007, 2008, and 2009, respectively. No impact on clinical malaria was observed.

Conclusion: IPTsc with SP+AS reduced the rates of all-cause clinic visits and anemia during a three-year implementation.

Keywords: IPTsc; Mali; artemisinin-based combination therapy; malaria; morbidity.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Study profile.
Figure 2
Figure 2
The prevalence of Plasmodium sp. in the treatment arms—monthly and by years.
See this image and copyright information in PMC

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