Maloprim malaria prophylaxis in children living in a holoendemic village in north-eastern Tanzania
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A randomized, double-'blind', placebo-controlled trial of weekly Maloprim (dapsone-pyrimethamine, D-P) for malaria prophylaxis was conducted at Magoda village in north-eastern Tanzania. The effect of D-P on the incidence of clinical malaria, Plasmodium falciparum prevalence and density, splenomegaly, and packed cell volume (PCV) was investigated in a cohort of 249 children (126 receiving D-P and 123 receiving placebo) aged 1-9 years. The case definition of clinical malaria (malaria fever) was measured axillary temperature > or = 37.5 degrees C and/or reported fever, and P. falciparum asexual parasitaemia > or = 5000/microL. Children aged 1-4 years given D-P experienced 1.56 episodes of clinical malaria per year, whereas children on placebo experienced 2.55 episodes (relative rate [RR] = 0.61, 95% confidence interval [CI] 0.47, 0.80). Thus, D-P protective efficacy against clinical malaria, in this age group, was 39% (95% CI 20%, 53%; P = 0.0002). The annual incidence of clinical malaria among children aged 5-9 years was 0.16 episodes in the D-P group and 0.26 episodes in those receiving placebo (RR = 0.58, 95% CI 0.26, 1.28; P = 0.17). Increased malaria transmission and drug resistance, during the course of the trial, resulted in a reduction in the protective efficacy of D-P. Overall, D-P was able to reduce parasite densities and splenomegaly. D-P prophylaxis also resulted in an increase in PCV but this effect diminished towards the end of the trial. D-P exerted a suppressive effect on asexual parasitaemia throughout the trial.
Original language | English |
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Journal | Transactions of the Royal Society of Tropical Medicine and Hygiene |
Volume | 91 |
Issue number | 1 |
Pages (from-to) | 68-73 |
Number of pages | 5 |
ISSN | 0035-9203 |
Publication status | Published - 1997 |
Bibliographical note
Keywords: Anti-Infective Agents; Child; Child, Preschool; Cohort Studies; Dapsone; Double-Blind Method; Drug Combinations; Drug Resistance; Female; Fever; Follow-Up Studies; Hematocrit; Humans; Infant; Malaria; Male; Parasitemia; Patient Compliance; Prospective Studies; Pyrimethamine; Splenomegaly; Tanzania; Treatment Outcome
ID: 9830717