Malaria in Infants Aged Less Than Six Months
Malaria in Infants Aged Less Than Six Months
Previous studies have shown that chemoprophylaxis in infants has the potential to reduce malaria-related morbidity and mortality. In The Gambia, infants receiving weekly chloroquine from birth until the age of two years had fewer episodes of malaria, grew better, and had higher haemoglobin levels than the control group.
Some studies of intermittent preventive treatment (IPT) in infants (IPTi) have timed the doses of anti-malarial to coincide with routine vaccinations delivered by WHO's Expanded Programme on Immunization (EPI) at 2, 3 and 9 months. In a pooled analysis of six randomized, placebo-controlled trials of IPTi using sulphadoxine-pyrimethamine delivered at the same time as EPI immunizations, a protective efficacy against clinical malaria of 30.3% was reported.
Seasonal malaria chemoprevention (SMC), previously referred to as IPT in children (IPTc), involves the administration of full anti-malarial treatment courses during the malaria season to children aged 3–59 months. The WHO recommends that SMC be used in areas of high seasonal malaria transmission across sub-Saharan Africa, and that treatment with amodiaquine plus sulphadoxine-pyrimethamine should be given at monthly intervals from the start of the transmission season, up to a maximum of four doses. The main potential risks associated with SMC are safety and drug resistance. However, SMC may provide a substantial protective effect against malaria, and is a potentially valuable tool that could contribute to reducing the malaria burden in infants aged over three months in areas with seasonal transmission.
The candidate malaria vaccine RTS,S/AS01 administered to infants aged 6–12 weeks at the time of the first vaccination provided modest protection against both uncomplicated and severe malaria, casting doubts on whether this vaccine could be included in the routine panel of infants' immunization. However, additional analyses are needed to understand the reasons of the observed lower efficacy in young infants as compared with older infants and children (aged 5–17 months).
Preventive Treatment
Previous studies have shown that chemoprophylaxis in infants has the potential to reduce malaria-related morbidity and mortality. In The Gambia, infants receiving weekly chloroquine from birth until the age of two years had fewer episodes of malaria, grew better, and had higher haemoglobin levels than the control group.
Some studies of intermittent preventive treatment (IPT) in infants (IPTi) have timed the doses of anti-malarial to coincide with routine vaccinations delivered by WHO's Expanded Programme on Immunization (EPI) at 2, 3 and 9 months. In a pooled analysis of six randomized, placebo-controlled trials of IPTi using sulphadoxine-pyrimethamine delivered at the same time as EPI immunizations, a protective efficacy against clinical malaria of 30.3% was reported.
Seasonal malaria chemoprevention (SMC), previously referred to as IPT in children (IPTc), involves the administration of full anti-malarial treatment courses during the malaria season to children aged 3–59 months. The WHO recommends that SMC be used in areas of high seasonal malaria transmission across sub-Saharan Africa, and that treatment with amodiaquine plus sulphadoxine-pyrimethamine should be given at monthly intervals from the start of the transmission season, up to a maximum of four doses. The main potential risks associated with SMC are safety and drug resistance. However, SMC may provide a substantial protective effect against malaria, and is a potentially valuable tool that could contribute to reducing the malaria burden in infants aged over three months in areas with seasonal transmission.
The candidate malaria vaccine RTS,S/AS01 administered to infants aged 6–12 weeks at the time of the first vaccination provided modest protection against both uncomplicated and severe malaria, casting doubts on whether this vaccine could be included in the routine panel of infants' immunization. However, additional analyses are needed to understand the reasons of the observed lower efficacy in young infants as compared with older infants and children (aged 5–17 months).