Intermittent Treatment With Sulfadoxine-pyrimethamine for Malaria Control in Infants

Intermittent Treatment With Sulfadoxine-pyrimethamine for Malaria Control in Infant: a Randomized, Double-blind, and Placebo-controlled Clinical Trial

German Federal Ministry of Education and Research, Deutscher Akademischer Austausch Dienst, The Volkswagen Foundation

The purpose of this study is to assess the effectiveness of Intermittent Preventive Treatment in Infants (IPTi) with Sulfadoxine-Pyrimethamine to reduce the numbers of malaria attacks, episodes of anemia, and the overall morbidity and mortality

In order to define the effectiveness of Intermittent Preventive Treatment in Infants (IPTi) with Sulfadoxine-Pyrimethamine, a novel principle of malaria intervention, the following parameters are evaluated: i) the level of protection from malaria attacks and episodes of anemia during the treatment period, ii) the level of protection from severe malaria during the treatment period, iii) the effect on malaria morbidity after sustaining treatment, iv) the decrease of overall morbidity and mortality, including the number of hospital admissions and visits of hospital outpatient departments v) the influence of the intervention on the development of drug resistances, vi) the impact of the intervention on the development of immunity, vii) the possible influence of the intervention on sub-clinical organ dysfunction due to chronic Plasmodium falciparum infection. Parts of the study are performed in collaboration with the Laboratory of Research, Hospital Albert Schweitzer, Lambaréné, Gabon and the School of Medicine and Health Sciences, University of Development Studies, Tamale, Ghana

Malaria, Anemia, IPTi, Intermittent Preventive Treatment in Infants, Sulfadoxine-Pyrimethamine, Chemoprophylaxis, Ghana

• Efficacy of an extended intermittent treatment with sulfadoxine-pyrimethamine for the control of clinical malaria and anemia (proportion and rates of children with one or more episodes of malaria or anemia in the age of 3 to 21 months of life)

• Determination of the rate of clinical malaria and anemia after suspending an extended intermittent treatment for analysis of possible rebound effects

• Evaluation of safety and adverse effects of the administration of single doses of sulfadoxine-pyrimethamine in infants and children

• Proportion and rates of children with one or more episodes of malaria or anemia in the age of 3 to 12 months of life

Inclusion Criteria: Informed consent by parent/guardian (written or oral) Permanent residentship in the study area Age of 3 months +/-4 weeks Exclusion Criteria: Hypersensitivity to sulfonamides or pyrimethamine (skin rashes, evidence of hemolysis including dark urine and/or purpura, presumptive signs of bone marrow depression such as sore throat and/or mouth ulcers) Other severe adverse events related to pyrimethamine-sulfadoxine application Signs of severe hepatic or renal dysfunction not due to malaria Other reasons after decision of the study physician

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