Intermittent Preventive Treatment for Malaria in Infants in Navrongo Ghana

London School of Hygiene and Tropical Medicine

Status: Completed

Conditions: Malaria; Anaemia

Treatments: Drug: Placebo; Drug: Sulfadoxine-pyrimethamine

Study type: Interventional

Funder types: Other

Identifiers

NCT00857077

DFID-R7602

Details and patient eligibility

About

Evaluation of the safety and effectiveness of malaria intermittent chemotherapy and iron supplementation delivered through Expanded Programme on Immunisation vaccination clinics.

Full description

Anaemia is one of the main disease burdens of children in developing countries. Severe anaemia is often fatal, while moderate anaemia leads to growth and cognitive disorders. The incidence of anaemia in children is extremely high in malaria endemic areas since episodes of clinical malaria and asymptomatic parasitaemia result in red cell destruction. It has been shown in Tanzania that the incidence of severe anaemia in infants can be reduced by 30% by regular administration of iron supplements, and by 60% if regular malaria chemoprophylaxis is given in addition. One way to operationalise this research finding, with minimal additional cost to governments and communities, is to link the distribution of iron and antimalarial drugs to the EPI programme. We propose a community-randomised trial to study the effectiveness of intermittent iron supplements and malaria chemotherapy in reducing the incidence of anaemia and clinical malaria, and to investigate any possible interactions of iron and antimalarial drugs with EPI vaccines. The study will have two arms: children in both arms will receive monthly supplies of twice weekly iron supplements when they attend EPI and growth monitoring clinics. In addition, children in arm 1 will receive a placebo when they receive Polio/DPT 2, Polio/DPT 3 and measles vaccines, while those in arm 2 will receive sulfadoxine-pyrimethamine (SP). The baseline incidence of anaemia and malaria, and immune response to EPI vaccines, will be estimated in a sample of children from a non-intervention area adjacent to the study area. The immune response to EPI vaccines, drug side-effects, and the incidence of anaemia and malaria will be compared between the two arms of the study and with the non-intervention area. Any possible 'rebound' in malaria incidence due to impairment of immunity will be monitored and treated during the six months after stopping the chemotherapy and supplementation.

Enrollment: 2,485 patients

Sex: All

Ages: 2 to 24 months old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• All infants living in study clusters without a history of allergy to sulfadoxine-pyrimethamine were eligible for enrollment in the study.

Exclusion criteria

• History of allergy to sulfadoxine-pyrimethamine.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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2,485 participants in 2 patient groups, including a placebo group

1 Placebo

Placebo Comparator group

Treatment:

Drug: Placebo

2 Sulfadoxine-pyrimethamine (SP)

Active Comparator group

Treatment:

Drug: Sulfadoxine-pyrimethamine