@article{fdi:010048495,
  title = {{A} trial of thee efficacy, safety and impact on drug resistance of four drug regimens for seasonal intermittent preventive treatment for malaria in senegalese children},
  author = {{S}okhna, {C}heikh and {C}isse, {B}. and {B}a, {E}. {H}. and {M}illigan, {P}. and {H}allett, {R}. and {S}utherland, {C}. and {G}aye, {O}. and {B}oulanger, {D}enis and {S}imondon, {K}irsten and {S}imondon, {F}ran{\c{c}}ois and {T}argett, {G}. and {L}ines, {J}. and {G}reenwood, {B}. and {T}rape, {J}ean-{F}ran{\c{c}}ois},
  editor = {},
  language = {{ENG}},
  abstract = {{I}n the {S}ahel, most malaria deaths occur among children 1-4 years old during a short transmission season. {A} trial of seasonal intermittent preventive treatment ({IPT}) with sulfadoxine-pyrimethamine ({SP}) and a single dose of artesunate ({AS}) showed an 86% reduction in the incidence of malaria in {S}enegal but this may not be the optimum regimen. {W}e compared this regimen with three alternatives. {M}ethods. 2102 children aged 6-59 months received either one dose of {SP} plus one dose of {AS} ({SP}+1{AS}) ( the previous regimen), one dose of {SP} plus 3 daily doses of {AS} ({SP}+3{AS}), one dose of {SP} plus three daily doses of amodiaquine ({AQ}) ({SP}+3{AQ}) or 3 daily doses of {AQ} and {AS} (3{AQ}+3{AS}). {T}reatments were given once a month on three occasions during the malaria transmission season. {T}he primary end point was incidence of clinical malaria. {S}econdary end-points were incidence of adverse events, mean haemoglobin concentration and prevalence of parasites carrying markers of resistance to {SP}. {F}indings. {T}he incidence of malaria, and the prevalence of parasitaemia at the end of the transmission season, were lowest in the group that received {SP}+3{AQ}: 10% of children in the group that received {SP}+1{AS} had malaria, compared to 9% in the {SP}+3{AS} group (hazard ratio {HR} 0.90, 95% {CI} 0.60, 1.36); 11% in the 3{AQ}+3{AS} group, {HR} 1.1 (0.76-1.7); and 5% in the {SP}+3{AQ} group, {HR} 0.50 (0.30-0.81). {M}utations associated with resistance to {SP} were present in almost all parasites detected at the end of the transmission season, but the prevalence of {P}lasmodium falciparum was very low in the {SP}+3{AQ} group. {C}onclusions. {M}onthly treatment with {SP}+3{AQ} is a highly effective regimen for seasonal {IPT}. {C}hoice of this regimen would minimise the spread of drug resistance and allow artemisinins to be reserved for the treatment of acute clinical malaria. {T}rial {R}egistration. {C}linicaltrials.gov {NCT}00132548},
  keywords = {},
  booktitle = {},
  journal = {{P}los {O}ne},
  volume = {3},
  numero = {1},
  pages = {e1471},
  ISSN = {1932-6203},
  year = {2008},
  DOI = {10.1371/journal.pone.0001471},
  URL = {https://www.documentation.ird.fr/hor/fdi:010048495},
}