@article{fdi:010093843,
  title = {{R}andomized trial of {P}iperaquine with {S}ulfadoxine-{P}yrimethamine or {D}ihydroartemisinin for malaria intermittent preventive treatment in children},
  author = {{C}isse, {B}. and {C}airns, {M}. and {F}aye, {E}. and {N}diaye, {O}. and {F}aye, {B}. and {C}ames, {C}{\'e}cile and {C}heng, {Y}. and {N}diaye, {M}. and {C}oll{\'e} {L}{\^o}, {A}. and {S}imondon, {K}. and {T}rape, {J}ean-{F}ran{\c{c}}ois and {F}aye, {O}. and {N}diaye, {J}.{L}. and {G}reenwood, {B}. and {M}illigan, {P}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground : {T}he long terminal half life of piperaquine makes it suitable for intermittent preventive treatment for malaria but no studies of its use for prevention have been done in {A}frica. {W}e did a cluster randomized trial to determine whether piperaquine in combination with either dihydroartemisin ({DHA}) or sulfadoxine-pyrimethamine ({SP}) is as effective, and better tolerated, than {SP} plus amodiaquine ({AQ}), when used for intermittent preventive treatment in children delivered by community health workers in a rural area of {S}enegal.


{M}ethods : {T}reatments were delivered to children 3-59 months of age in their homes once per month during the transmission season by community health workers. 33 health workers, each covering about 60 children, were randomized to deliver either {SP}+{AQ}, {DHA}+{PQ} or {SP}+{PQ}. {P}rimary endpoints were the incidence of attacks of clinical malaria, and the incidence of adverse events.


{R}esults : 1893 children were enrolled. {C}overage of monthly rounds and compliance with daily doses was similar in all groups; 90% of children received at least 2 monthly doses. {P}iperaquine combinations were better tolerated than {SP}+{AQ} with a significantly lower risk of common, mild adverse events. 103 episodes of clinical malaria were recorded during the course of the trial. 68 children had malaria with parasitaemia >3000/µ{L}, 29/671 (4.3%) in the {SP}+{AQ} group, compared with 22/604 (3.6%) in the {DHA}+{PQ} group (risk difference 0.47%, 95%{CI} ?2.3%,+3.3%), and 17/618 (2.8%) in the {SP}+{PQ} group (risk difference 1.2%, 95%{CI} ?1.3%,+3.6%). {P}revalences of parasitaemia and the proportion of children carrying {P}fdhfr and {P}fdhps mutations associated with resistance to {SP} were very low in all groups at the end of the transmission season.


{C}onclusions : {S}easonal {IPT} with {SP}+{PQ} in children is highly effective and well tolerated; the combination of two long-acting drugs is likely to impede the emergence of resistant parasites.},
  keywords = {{SENEGAL}},
  booktitle = {},
  journal = {{PL}o{S} {ONE}},
  volume = {4},
  numero = {9},
  pages = {e7164 [10 ]},
  ISSN = {1932-6203},
  year = {2009},
  DOI = {10.1371/journal.pone.0007164},
  URL = {https://www.documentation.ird.fr/hor/fdi:010093843},
}