Chemoprophylaxis and intermittent treatment for preventing malaria in children

Meremikwu, MM; Omari, AAA; Garner, Paul

doi:10.1002/14651858.cd003756.pub2

Cited by 17 publications

(11 citation statements)

References 68 publications

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“…Most of these studies focused on young children, but in 30 of the 36 trials that examined infection rates in children over 5 years of age, reductions in malaria parasitaemia ranging from 21 to 100% were seen. A more recent review confirmed these findings (Meremikwu et al 2008). At the time when malaria parasites were highly sensitive to choloquine, 'chloroquinisation' of schoolchildren during the peak transmission season was widely deployed in some countries in West Africa such as Senegal.…”

Section: Prevention Of Malaria In School-age African Childrenmentioning

confidence: 85%

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Malaria in school‐age children in Africa: an increasingly important challenge

Nankabirwa

Brooker

Clarke

et al. 2014

Tropical Med Int Health

172

184

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School-age children have attracted relatively little attention as a group in need of special measures to protect them against malaria. However, increasing success in lowering the level of malaria transmission in many previously highly endemic areas will result in children acquiring immunity to malaria later in life than has been the case in the past. Thus, it can be anticipated that in the coming years there will be an increase in the incidence of both uncomplicated and severe malaria in school-age children in many previously highly endemic areas. In this review, which focuses primarily on Africa, recent data on the prevalence of malaria parasitaemia and on the incidence of clinical malaria in African school-age children are presented and evidence that malaria adversely effects school performance is reviewed. Long-lasting insecticide treated bednets (LLIN) are an effective method of malaria control but several studies have shown that school-age children use LLINs less frequently than other population groups. Antimalarial drugs are being used in different ways to control malaria in school-age children including screening and treatment and intermittent preventive treatment. Some studies of chemoprevention in school-age children have shown reductions in anaemia and improved school performance but this has not been the case in all trials and more research is needed to identify the situations in which chemoprevention is likely to be most effective and, in these situations, which type of intervention should be used. In the longer term, malaria vaccines may have an important role in protecting this important section of the community from malaria. Regardless of the control approach selected, it is important this is incorporated into the overall programme of measures being undertaken to enhance the health of African school-age children.

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Section: Prevention Of Malaria In School-age African Childrenmentioning

confidence: 85%

“…A more recent review confirmed these findings (Meremikwu et al . ). At the time when malaria parasites were highly sensitive to choloquine, ‘chloroquinisation’ of schoolchildren during the peak transmission season was widely deployed in some countries in West Africa such as Senegal.…”

Section: Methodsmentioning

confidence: 97%

Malaria in school‐age children in Africa: an increasingly important challenge

Nankabirwa

Brooker

Clarke

et al. 2014

Tropical Med Int Health

172

184

View full text Add to dashboard Cite

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“…Schools also can serve as hubs for ITN distribution, and boarding schools in endemic areas should equip their dormitories with ITNs. Chemoprophylaxis or intermittent preventive treatment (IPT) have shown to reduce malaria-associated morbidity in school children [42, 43]. IPT, also termed intermittent parasite clearance in schools (IPCs) or seasonal malaria chemoprevention (SMC), needs to account for the epidemiological characteristics of malaria in a given area, and can greatly reduce the proportion of Plasmodium infected children (reviewed in Ref.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic only at first sight: malaria infection among schoolchildren in highland Rwanda

Sifft

Geus

Mukampunga

et al. 2016

Malar J

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Background Plasmodium infection and malaria in school children are increasingly recognized as a relevant public health problem, but data on actual prevalence and health consequences are insufficient. The present study from highland southern Rwanda aimed at estimating infection prevalence among children attending school, at identifying associated factors and at assessing the clinical consequences of these infections.MethodsIn a survey including 12 schools in the Huye district of Rwanda, 1089 children aged 6–10 years were clinically and anthropometrically examined, malaria parasites were diagnosed by microscopy and PCR, haemoglobin concentrations were measured, and socio-economic and behavioural parameters as well as medical histories were obtained.ResultsUpon examination, the vast majority of children was asymptomatic (fever 2.7%). Plasmodium infection was detected in 22.4% (Plasmodium falciparum, 18.8%); 41% of these were submicroscopic. Independent predictors of infection included low altitude, higher age, preceding antimalarial treatment, and absence of electricity or a bicycle in the household. Plasmodium infection was associated with anaemia (mean haemoglobin difference of −1.2 g/dL; 95% CI, −0.8 to −1.5 g/dL), fever, underweight, clinically assessed malnutrition and histories of fever, tiredness, weakness, poor appetite, abdominal pain, and vomiting. With the exception of underweight, these conditions were also increased at submicroscopic infection.ConclusionMalaria infection is frequent among children attending school in southern highland Rwanda. Although seemingly asymptomatic in the vast majority of cases, infection is associated with a number of non-specific symptoms in the children´s histories, in addition to the impact on anaemia. This argues for improved malaria surveillance and control activities among school children.

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“…Importantly, the protection afforded by access to treatment and prevention delivered through imperfect health systems is equivalent to that offered by alternative interventions such as anti‐malaria vaccine candidates (Alonso et al. 2004) and intermittent preventive treatment (Meremikwu et al. 2008) in carefully controlled efficacy studies.…”

Section: Discussionmentioning

confidence: 99%

The impact of primary health care on malaria morbidity – defining access by disease burden

O’Meara

Noor

Gatakaa

et al. 2009

Tropical Med Int Health

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Objectives The convergence of malaria endemicity and poor health care infrastructure has resulted in persistently high rates of malaria morbidity and mortality in many parts of sub-Saharan Africa. Primary care facilities are increasingly becoming the focal point for distribution of intervention strategies, but physical access to these facilities may limit the extent to which communities can be reached. Here we investigate the impact of travel time to primary care on the incidence of hospitalized malaria episodes in a rural district in Kenya. Methods The incidence of hospitalized malaria in a population under continuous demographic surveillance was recorded over three years. The time to travel to the nearest primary health care facility was calculated for every child between birth and five years of age and trends in incidence of hospitalized malaria as a function of travel time were evaluated. Results and conclusions We show that the incidence of hospitalized malaria more than doubled as travel time to the nearest primary care facility increased from ten minutes up to two hours. Good access to primary health facilities may reduce the burden of disease by as much as 66%. Our results highlight both the potential of the primary health care system in reaching those most at risk and reducing the disease burden, and that insufficient access is an important risk factor, one that may be inequitably distributed to the poorest households.

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Chemoprophylaxis and intermittent treatment for preventing malaria in children

Abstract: Prophylaxis and intermittent treatment with antimalarial drugs reduce clinical malaria and severe anaemia in preschool children. There is insufficient evidence to detect an effect on mortality.

Cited by 17 publications

References 68 publications

Malaria in school‐age children in Africa: an increasingly important challenge

Malaria in school‐age children in Africa: an increasingly important challenge

Asymptomatic only at first sight: malaria infection among schoolchildren in highland Rwanda

The impact of primary health care on malaria morbidity – defining access by disease burden

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