A large-scale trial by the Medical Research Council (UK) The Gambia has corroborated the findings of two other trials in Mali and Burkina Faso, carried out to improve the health of children affected by malaria, an infection responsible for one in five childhood deaths in Africa.

All three trials separately found that the chances becoming infected with malaria were reduced by up to 85 per cent when intermittent preventive treatment in children (IPTc) was combined with the use of insecticide-treated bednets (ITNs), the main tool currently used to protect people against malaria in sub-Saharan Africa.

The three studies are published this week in the journal Public Library of Science (PLoS) Medicine. The studies provide further evidence to support IPTc being integrated into programmes designed to control malaria, particularly in areas that seriously affected by a higher rate of malaria infection during warm periods of the rainy season.

Previous clinical trials have shown that seasonal IPTc, which involves the administration of two or three doses of antimalarial drugs during the high malaria transmission season, has successfully reduced the number of people suffering malaria. Sleeping underneath ITNs has been shown to prevent malaria by 50 per cent, however these are the first studies to specifically look into the effectiveness of IPTc in communities such as the Sahel and sub-Sahel, where people are less likely to use ITNs.

The focus of the Gambian study, involving 1,277 children under five, was to determine the best way to deliver IPTc in rural communities, and found that IPTc could be easily administered to children by village health workers.

Dr Kalifa Bojang from the Medical Research Council (UK) The Gambia, and principal investigator for the trial carried out in The Gambia, said:

"These findings indicate that IPTc is a potentially valuable tool for the control of malaria in areas with seasonal transmission and can easily be administered by village health workers in a cost-effective manner." Professor Brian Greenwood from the London School of Hygiene & Tropical Medicine, and co-author of all three studies, said:

"The findings of these studies and of a recent review which suggests that IPTc can reduce overall child mortality substantially suggests that IPTc now warrants serious consideration as a valuable component of a combined malaria control strategy in areas where malaria transmission is seasonal."

These studies were conducted as a collaboration between the Centre National de Recherche et de Formation sur le Paludisme, Ougadougou, Burkina Faso, the Malaria Research and Training Centre, University of Bamako, Mali, the Medical Research Council (UK) The Gambia and the London School of Hygiene and Tropical Medicine.

Medical Research Council

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