AsianScientist (Apr. 2, 2012) – Malaria infections among infants can be reduced by 30 percent when antimalarial drugs are given intermittently over 12 months, according to a three-year clinical trial in Papua New Guinea.
The drug regimen has been shown to effectively prevent infections by both Plasmodium falciparum and Plasmodium vivax malaria, the first among antimalarial drugs.
Called intermittent preventive treatment (IPT), the regimen protected the infants against malaria for at least six weeks after the treatment ended, showing that it had an ongoing protective effect and did not hinder the development of natural immunity.
The study was led by Professor Ivo Mueller from the Walter and Eliza Hall Institute’s Infection and Immunity division and Barcelona Center for International Health Research (CRESIB), with Dr. Patricia Rarau and Dr. Nicolas Senn from the Papua New Guinea Institute of Medical Research (PNGIMR).
Mueller said the findings could lead to trials of IPT in other regions, including Southeast Asia and South America, where P. vivax is the main cause of clinical malaria in infants.
“What this study has shown is that IPT can be useful in regions other than sub-Saharan Africa, that it can be an effective tool against P.vivax, and reaffirms that we need to effectively tailor preventive drugs to different malaria species in different regions.” Mueller said.
IPT uses sporadic, short courses of combined antimalarial drugs, a cheap and easy way to decrease the burden of malaria in populations that are most susceptible to clinical illness, such as young infants and pregnant women.
As part of the clinical trial, infants aged three to 15 months were treated with a combination of long-lasting antimalarial drugs at 3, 6, 9, and 12 months. The most effective drug combination in the trial contained the long-lasting antimalarials sulfadoxine/pyrimethamine and amodiaquine (SP-AQ), which cut infant infections by 35 percent for P. falciparum and P. vivax.
“These are quite remarkable figures,” Mueller remarked. ”Different treatment strategies are required for different regions, depending on the dynamics of disease. The drug combination that was most effective in PNG was very different to the drugs you would use to treat malaria in Africa and also different to the drugs currently recommended for treating malaria in PNG,” he said.
Professor Peter Siba, director of PNGIMR, said that it was key to execute the treatment in parallel with existing vaccination and healthcare programs, as it led to much higher adherence than with continuous treatment regimens. IPT is also preferable to long-term, continued use of antimalarial drugs, as it allows some natural immunity to develop while reducing the number and severity of malaria infections.
The article can be found at: Senn N et al. (2012) Intermittent Preventive Treatment for Malaria in Papua New Guinean Infants Exposed to Plasmodium falciparum and P. vivax: A Randomized Controlled Trial.
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Source: Walter and Eliza Hall Institute of Medical Research.
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