Brussels, Feb 2006
Researchers from the London School of Hygiene and Tropical Medicine have achieved an astounding 86 per cent reduction in malarial infections in children under five during a study carried out in Senegal.
Results published in The Lancet follow the randomised, placebo-controlled trial which took 1,136 children aged between two months and five years. Candidates were given intermittent doses of either the prophylactic combination of artesunate and pyrimethamine (Daraprim) or placebos.
The control group was found to have an incidence of malaria of 2,250 episodes per 1,000 person years, while the prophylactic group had an instance of 308 episodes per 1,000 person years. This is a reduction of 86 per cent in the prophylactic group. The side-effects were limited to bouts of vomiting in a small number of those given the active drugs.
Malaria causes an estimated 1.3 million deaths annually, the vast majority of these deaths - 90 per cent - occurring in sub-Saharan Africa. Children under the age of five and pregnant women are the groups most at risk.
In Senegal specifically, rates of malaria have increased throughout the 1990s because of the rising resistance of strains to treatments. This trial administered preventative quantities of the anti-malarial drugs, which are lower than concentrations used to treat the illness once malaria has been contracted.
Dr Badara Cisse, formerly of the London School of Hygiene and Tropical Medicine and now at the University of Dakar in Senegal, was the lead researcher on the project. 'Seasonal intermittent preventative treatment is simple, cheap and dramatic in its impact on children under five in areas of seasonal malarial transmission,' he said. 'The results of this trial are very encouraging, but we do need to carry out further studies into whether the treatment can be delivered on a bigger scale. If we are to ensure higher rates of coverage, then we need to bring the whole community on board. There is also the question of what the effect might be on drug resistance, which needs to be further explored.'