A Cochrane review [Abstract] 1 included 7 trials with 12589 participants. All were conducted in West Africa, and six of seven trials were restricted to children aged less than 5 years.
Intermittent Preventive Treatment in children (IPTc) prevents approximately three quarters of all clinical malaria episodes (rate ratio 0.26; 95% CI 0.17 to 0.38; 9321 participants, six trials), and a similar proportion of severe malaria episodes (rate ratio 0.27, 95% CI 0.10 to 0.76; 5964 participants, two trials). These effects remain present even where insecticide treated net (ITN) usage is high (two trials, 5964 participants).IPTc probably produces a small statistically non-significant reduction in all-cause mortality consistent with the effect on severe malaria (risk ratio 0.66, 95% CI 0.31 to 1.39).The risk of moderately severe anaemia is probably lower with IPTc (risk ratio 0.71, 95% CI 0.52 to 0.98; 8805 participants, five trials).Serious drug-related adverse events, if they occur, are probably rare, with none reported in the six trials (9533 participants, six trials). Amodiaquine plus sulphadoxine-pyrimethamine is the most studied drug combination for seasonal chemoprevention. Although effective, it causes increased vomiting in this age-group (risk ratio 2.78, 95% CI 2.31 to 3.35; two trials, 3544 participants).When antimalarial IPTc was stopped, no rebound increase in malaria was observed in the three trials which continued follow-up for one season after IPTc.
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