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Evidence summaries

Malaria Chemoprophylaxis in Sickle Cell Disease

Routine malaria chemoprophylaxis in sickle cell disease appears to be beneficial in areas where malaria is endemic. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 2 studies with a total of 223 children with homozygous sickle cell disease. A randomized controlled trial in Nigeria compared two different antimalarial drugs with a placebo, and reported that chemoprophylaxis reduced sickle cell crises (RR 0.17, 95% CI 0.04 to 0.83; 97 children), hospital admissions (RR 0.27, 95% CI 0.12 to 0.63; 97 participants), and blood transfusions (RR 0.16, 95% CI 0.05 to 0.56; 97 participants). A quasi-randomized controlled trial of 126 children in Uganda compared an antimalarial drug plus antibiotics with no antimalarial plus placebo. Chemoprophylaxis reduced the number of episodes of malaria and dactylitis, and increased mean haemoglobin values in this trial.

Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals).

    References

    • Oniyangi O, Omari AAA. Malaria chemoprophylaxis in sickle cell disease. Cochrane Database Syst Rev. 2006;(4):CD003489.

Primary/Secondary Keywords