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Cluster-randomized controlled trial of intermittent preventive treatment in infancy using sulfadoxine-pyrimethamine (SP-IPTi): a pilot study in Nigeria.
Journal of Tropical Pediatrics ( IF 2 ) Pub Date : 2022-12-05 , DOI: 10.1093/tropej/fmad001
Olumide Thomas Adeleke 1 , Abayomi Oyenuga 2 , Tina M Slusher 1, 2, 3 , Daniel A Gbadero 1
Affiliation  

BACKGROUND Malaria kills a child in sub-Saharan Africa every 2 min despite widely available interventions including intermittent preventive treatment in infants (IPTi). Since 2010, when World Health Organization (WHO) recommended IPTi, no country has implemented it. To our knowledge, no IPTi study has been conducted in Nigeria. Considering severity of malaria in infancy and urgency to improve malaria prevention, we proposed a study to investigate the efficacy of this intervention in reducing malarial morbidity and mortality. OBJECTIVE(S) The aim of this was to determine the safety and efficacy of SP-IPTi in reducing the prevalence of asymptomatic malaria parasitemia and malarial-associated hospital admissions. METHODS We performed a cluster-randomized controlled trial in 1379 infants. SP was administered alongside routine vaccinations in immunization centers randomized to intervention groups. Infants in control groups received only routine vaccines. Malarial 'morbidity and adverse events were monitored through passive case-detection and cross-sectional surveys'. RESULTS SP-IPTi was safe. There was no statistically significant difference in terms of risks of asymptomatic parasitemia at 9 months, fever or hospitalization between our control and intervention groups. CONCLUSIONS Our study demonstrated that SP-IPTi had no benefit but was well tolerated. WHO and some researchers have also reported declining efficacy of SP, due to increasing drug resistance.

中文翻译:

使用磺胺多辛-乙胺嘧啶 (SP-IPTi) 对婴儿进行间歇性预防性治疗的整群随机对照试验:尼日利亚的一项试点研究。

背景 疟疾在撒哈拉以南非洲地区每 2 分钟杀死一名儿童,尽管干预措施广泛可用,包括婴儿间歇性预防治疗 (IPTi)。自2010年世界卫生组织(WHO)推荐IPTi以来,一直没有国家实施。据我们所知,尚未在尼日利亚开展 IPTi 研究。考虑到婴儿期疟疾的严重程度和改善疟疾预防的紧迫性,我们提出了一项研究来调查这种干预措施在降低疟疾发病率和死亡率方面的功效。目的 本研究的目的是确定 SP-IPTi 在减少无症状疟疾寄生虫血症和疟疾相关住院率方面的安全性和有效性。方法 我们对 1379 名婴儿进行了整群随机对照试验。在随机分配到干预组的免疫中心,SP 与常规疫苗接种同时进行。对照组的婴儿仅接种常规疫苗。疟疾“通过被动病例检测和横断面调查监测发病率和不良事件”。结果 SP-IPTi 是安全的。我们的对照组和干预组在 9 个月时无症状寄生虫血症、发烧或住院的风险方面没有统计学上的显着差异。结论 我们的研究表明 SP-IPTi 没有益处,但耐受性良好。世卫组织和一些研究人员还报告说,由于耐药性增加,SP 的疗效下降。通过被动病例检测和横断面调查监测发病率和不良事件。结果 SP-IPTi 是安全的。我们的对照组和干预组在 9 个月时无症状寄生虫血症、发烧或住院的风险方面没有统计学上的显着差异。结论 我们的研究表明 SP-IPTi 没有益处,但耐受性良好。世卫组织和一些研究人员还报告说,由于耐药性增加,SP 的疗效下降。通过被动病例检测和横断面调查监测发病率和不良事件。结果 SP-IPTi 是安全的。我们的对照组和干预组在 9 个月时无症状寄生虫血症、发烧或住院的风险方面没有统计学上的显着差异。结论 我们的研究表明 SP-IPTi 没有益处,但耐受性良好。世卫组织和一些研究人员还报告说,由于耐药性增加,SP 的疗效下降。
更新日期:2022-12-05
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