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Impact of Intermittent Preventive Anti-Malarial Treatment on the Growth and Nutritional Status of Preschool Children in Rural Senegal (West Africa)

Negative consequences of malaria might account for seasonality in nutritional status in children in the Sahel. We report the impact of a randomized, double-blind, placebo-controlled trial of seasonal intermittent preventive anti-malarial treatment on growth and nutritional status in 1,063 Senegalese preschool children. A combination of artesunate and sulfadoxine-pyrimethamine was given monthly from September to November. In the intervention arm, mean weight gain was significantly greater (122.9 ± 340 versus 42.9 ± 344 [SD] g/mo, P < 0.0001) and losses in triceps and subscapular skinfold measurements were less (–0.39 ± 1.01 versus –0.66 ± 1.01 mm/mo, and –0.15 ± 0.64 versus –0.36 ± 0.62 mm/mo, respectively, P < 0.0001 for both). There was no difference in height increments. The prevalence of wasting increased significantly in the control arm (4.6% before versus 9.5% after, P < 0.0001), but remained constant in intervention children: 5.6% versus 7.0% (P = 0.62). The prevention of malaria would improve child nutritional status in areas with seasonal transmission.

Received January 25, 2007. Accepted for publication May 13, 2007.

Acknowledgments: The authors thank Amady Ndiaye, Tofène Ndiaye, and Bassirou Fall for taking the anthropometric measurements, Adama Marra for identification of eligible subjects and data management, Jacqueline Milet for help with anthropometric data management, Ernest Faye for supervision in the field, and the entire study field team for their work.

Financial support: The study was funded by the Gates Malaria Partnership, which receives support from the Bill and Melinda Gates Foundation, the LSHTM DFID Malaria Knowledge Programme, and the IRD.

^* Address correspondence to Kirsten B. Simondon, Centre IRD, BP 64501, 34394 Montpellier, France. E-mail: Kirsten{at}ird.fr

Authors’ addresses: Balthazar Ntab, François Simondon, and Kirsten B. Simondon, Centre IRD, BP 64501, 34394 Montpellier, France. Badara Cissé, UCAD, Service de Parasitologie, BP 5005, Dakar, Senegal. Denis Boulanger, Cheikh Sokhna, and Jean-François Trape, Centre IRD, BP 1386, CP18524, Dakar, Senegal. Geoffrey Targett, Jo Lines, Neal Alexander, and Brian Greenwood, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.