Spatiotemporal variations of malaria incidence and protective efficacy of intermittent preventive antimalarial treatment of infants

Abstract number: 1732_48

May J., Kobbe R., Kreuels B., Adjei S., Adjei on behalf of the Agona IPTi Trial Team O.

Background: Intermittent preventive antimalarial treatment of infants (IPTi) is considered a promising malaria control strategy. Among the factors that influence the extent of protection provided by IPTi are malaria endemicity, seasonality, drug resistance patterns and the IPTi application schedule. Studies modeling the effect of malaria incidences on IPTi are scarce. The aim of this study was to describe how far protective efficacy of IPTi depends on the incidence rate of clinical malaria.

Methods: One-thousand seventy infants were enrolled in a registered controlled trial on the efficacy of sulfadoxine-pyrimethamine based IPTi in the Ashanti Region, Ghana. In an ecological analysis, malaria incidence rates in the first year following IPTi were stratified by the village of residence and month of birth of participants and the spatiotemporal variation of the malaria incidence on the protective efficacy of IPTi was analysed.

Findings: The rate of malaria attacks during the first year of follow-up was highly dependent on the month of birth and on the village of residence of the children. Protective efficacy of the first IPTi administration (IPTi-1) correlated with malaria incidences in children living in a particular village or born in a particular month (r2 0.48, p < 0.04 and r2 0.63, p < 0.003, respectively). A corresponding trend was seen after the second (IPTi-2) and third (IPTi-3) drug administration.

Interpretation: Correlations between IPTi efficacy and malaria incidences may have implications on IPTi implementation strategies and, most likely, on that of other malaria control measures.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Location: ICC, Munich, Germany
Presentation type:
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