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Therapeutics/Prevention
Randomised controlled trial
Monthly malaria chemoprevention shows potential in an area of very high, perennial malaria transmission
  1. Matthew Cairns1,
  2. Patrick G T Walker2
  1. 1MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK;
  2. 2MRC Centre for Outbreak Analysis & Modelling, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
  1. Correspondence to : Dr Matthew Cairns, MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; matthew.cairns{at}lshtm.ac.uk

http://dx.doi.org/10.1136/ebmed-2015-110173

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    Commentary on: Bigira V, Kapisi J, Clark TD, et al. Protective efficacy and safety of three antimalarial regimens for the prevention of malaria in young Ugandan children: a randomized controlled trial. PLoS Med 2014;11:e1001689OpenUrlCrossRefPubMed.

    Context

    New approaches are needed for malaria control where the burden has remained high despite scaled up coverage of long-lasting insecticide-treated nets (LLIN) and prompt access to artemisinin-based combination therapies (ACTs).1 Bigira and colleagues evaluated three regimens for chemoprevention of malaria in young children in eastern Uganda, in an area of very high year-round malaria transmission and high resistance to antifolate drugs, including sulfadoxine-pyrimethamine (SP) and sulfamethoxazole.

    Methods

    Children between 6 and 24 months of age were randomised to receive daily trimethoprim-sulfamethoxazole (TS), monthly SP, monthly dihydroartemisinin-piperaquine (DP) or no intervention. All study participants were given LLINs. Follow-up continued to 36 months of age. The primary outcome was incidence of uncomplicated malaria, treated with artemether-lumefantrine (AL).

    Findings

    Between 6 and 24 months of age, …

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    Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/