Seasonal Malaria Chemoprevention Versus Home Management of Malaria in Children Under 5 Years in Ghana
Status:
Completed
Trial end date:
2013-07-01
Target enrollment:
Participant gender:
Summary
In areas of Africa where malaria is only a problem during a short rainy season, monthly
courses of antimalarial drugs can provide very effective prevention of malaria in children.
This approach, called intermittent preventive treatment in children (IPTc) but now known as
Seasonal Malaria Chemoprevention (SMC), may also be useful in large areas of Africa where
malaria is transmitted for longer each year. It is uncertain if IPTc would be effective,
acceptable to communities or sustainable when delivered over a longer period, but this is an
important public health question of key interest to policy makers, because in areas with a
longer transmission season, the burden of malaria is typically higher than in highly seasonal
areas.
Another form of prevention that would be operationally easier for African countries to put
into practice would be to treat malaria patients with long-lasting antimalarials, which
protect children against further malaria episodes for several weeks. Because malaria
disproportionately affects certain high risk children more than others, causing repeated
attacks of fever and leading to severe anaemia, long-acting drugs may be a simple and
effective way to target limited resources at the individuals who most need protection. This
may be particularly beneficial where malaria is a seasonal problem, because repeated malaria
attacks will not only be borne by a few unfortunate children, but will also occur close
together in time.
The investigators propose a clinical trial to evaluate these two forms of chemoprevention in
Kumasi, Ghana, an area with an extended malaria transmission season. Children under 5 years
of age currently have access to diagnosis and treatment of malaria via by community based
health workers. Children enrolled in the study will receive either the standard
community-based diagnosis and treatment, treatment with a longer-acting artemisinin
combination therapy (ACT), or standard care plus five monthly courses of seasonal malaria
chemoprevention (SMC) during the peak in transmission.
Phase:
Phase 4
Details
Lead Sponsor:
Centre for Global Health Research, Ghana
Collaborator:
London School of Hygiene and Tropical Medicine
Treatments:
Amodiaquine Artemether Artemether-lumefantrine combination Artemether, Lumefantrine Drug Combination Artemisinins Artenimol Dihydroartemisinin Fanasil, pyrimethamine drug combination Lumefantrine Piperaquine Pyrimethamine Sulfadoxine