Volume 82, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Intermittent preventive treatment of malaria in infants (IPTi) with sulphadoxine-pyrimethamine shows evidence of efficacy in individually randomized, controlled trials. In a large-scale effectiveness study, IPTi was introduced in April 2005 by existing health staff through routine contacts in 12 randomly selected divisions out of 24 in 6 districts of rural southern Tanzania. Coverage and effects on malaria and anemia were estimated through a representative survey in 2006 with 600 children aged 2–11 months. Coverage of IPTi was 47–76% depending on the definition. Using an intention to treat analysis, parasitemia prevalence was 31% in intervention and 38% in comparison areas ( = 0.06). In a “per protocol” analysis of children who had recently received IPTi, parasite prevalence was 22%, 19 percentage points lower than comparison children ( = 0.01). IPTi can be implemented on a large scale by existing health service staff, with a measurable population effect on malaria, within 1 year of launch.


Article metrics loading...

Loading full text...

Full text loading...



  1. Abdullah S, Adazu K, Masanja H, Diallo D, Hodgson A, Ilboudo-Sanogo E, Nhacolo A, Owusu-Agyei S, Thompson R, Smith T, Binka FN, , 2007. Patterns of age-specific mortality in children in endemic areas of sub-Saharan Africa. Am J Trop Med Hyg 77: 99105.[Crossref]
  2. Ross A, Penny M, Maire N, Studer A, Carneiro I, Schellenberg D, Greenwood B, Tanner M, Smith T, , 2008. Modelling the epidemiological impact of intermittent preventive treatment against malaria in infants. PLoS One 3: e2661.[Crossref]
  3. Masanja H, de Savigny D, Smithson P, Schellenberg J, John T, Mbuya C, Upunda G, Boerma T, Victora C, Smith T, Mshinda H, , 2008. Child survival gains Tanzania: analysis of data from demographic and health surveys. Lancet 371: 12761283.[Crossref]
  4. Hanson K, Marchant T, Nathan R, Mponda H, Jones C, Bruce J, Mshinda H, Armstrong J, , 2009. Household ownership and use of insecticide treated nets among target groups after implementation of a national voucher programme in the United Republic of Tanzania: plausibility study using three annual cross sectional household surveys. BMJ 339: b2434.[Crossref]
  5. Schellenberg D, Menendez C, Kahigwa E, Aponte J, Vidal J, Tanner M, Mshinda H, Alonso P, , 2001. Intermittent treatment for malaria and anaemia control at time of routine vaccinations in Tanzanian infants: a randomised, placebo-controlled trial. Lancet 357: 14711477.[Crossref]
  6. Massaga JJ, Kitua AY, Lemnge MM, Akida JA, Malle LN, Ronn AM, Theander TG, Bygbjerg IC, , 2003. Effect of intermittent treatment with amodiaquine on anaemia and malarial fevers in infants in Tanzania: a randomised placebo-controlled trial. Lancet 361: 18531860.[Crossref]
  7. Hutton G, Schellenberg D, Tediosi F, Macete E, Kahigwa E, Sigauque B, Mas X, Trapero M, Tanner M, Trilla A, Alonso P, Menendez C, , 2009. Cost-effectiveness of malaria intermittent preventive treatment in infants (IPTi) in Mozambique and the United Republic of Tanzania. Bull World Health Organ 87: 123129.[Crossref]
  8. Manzi F, Hutton G, Schellenberg J, Tanner M, Alonso P, Mshinda H, Schellenberg D, , 2008. From strategy development to routine implementation: the cost of intermittent preventive treatment in infants for malaria control. BMC Health Serv Res 8: 165.[Crossref]
  9. Pool R, Munguambe K, Macete E, Aide P, Juma G, Alonso P, Menendez C, , 2006. Community response to intermittent preventive treatment delivered to infants (IPTi) through the EPI system in Manhica, Mozambique. Trop Med Int Health 11: 16701678.[Crossref]
  10. Pool R, Mushi A, Schellenberg JA, Mrisho M, Alonso P, Montgomery C, Tanner M, Mshinda H, Schellenberg D, , 2008. The acceptability of intermittent preventive treatment of malaria in infants (IPTi) delivered through the expanded programme of immunization in southern Tanzania. Malar J 7: 213.[Crossref]
  11. Chandramohan D, Owusu-Agyei S, Carneiro I, Awine T, Amponsa-Achiano K, Mensah N, Jaffar S, Baiden R, Hodgson A, Binka F, Greenwood B, , 2005. Cluster randomised trial of intermittent preventive treatment for malaria in infants in area of high, seasonal transmission in Ghana. BMJ 331: 727733.[Crossref]
  12. Grobusch MP, Lell B, Schwarz NG, Gabor J, Dornemann J, Potschke M, Oyakhirome S, Kiessling GC, Necek M, Langin MU, Klouwenberg PK, Klopfer A, Naumann B, Altun H, Agnandji ST, Goesch J, Decker M, Salazar CLO, Supan C, Kombila DU, Borchert L, Koster KB, Pongratz P, Adegnika AA, von Glasenapp I, Issifou S, Kremsner PG, , 2007. Intermittent preventive treatment against malaria in infants in Gabon: a randomized, double-blind, placebo-controlled trial. J Infect Dis 196: 15951602.[Crossref]
  13. Kobbe R, Kreuzberg C, Adjei S, Thompson B, Langefeld I, Thompson PA, Abruquah HH, Kreuels B, Ayim M, Busch W, Marks F, Amoah K, Opoku E, Meyer CG, Adjei O, May J, , 2007. A randomized controlled trial of extended intermittent preventive antimalarial treatment in infants. Clin Infect Dis 45: 1625.[Crossref]
  14. Macete E, Aide P, Aponte JJ, Sanz S, Mandomando I, Espasa M, Sigauque B, Dobano C, Mabunda S, DgeDge M, Alonso P, Menendez C, , 2006. Intermittent preventive treatment for malaria control administered at the time of routine vaccinations in Mozambican infants: a randomized, placebo-controlled trial. J Infect Dis 194: 276285.[Crossref]
  15. Mockenhaupt FP, Reither K, Zanger P, Roepcke F, Danquah I, Saad E, Ziniel P, Dzisi SY, Frempong M, Agana-Nsiire P, Amoo-Sakyi F, Otchwemah R, Cramer JP, Anemana SD, Dietz E, Bienzle U, , 2007. Intermittent preventive treatment in infants as a means of malaria control: a randomized, double-blind, placebo-controlled trial in northern Ghana. Antimicrob Agents Chemother 51: 32733281.[Crossref]
  16. Schellenberg D, Menendez C, Aponte JJ, Kahigwa E, Tanner M, Mshinda H, Alonso P, , 2005. Intermittent preventive antimalarial treatment for Tanzanian infants: follow-up to age 2 years of a randomised, placebo-controlled trial. Lancet 365: 14811483.[Crossref]
  17. Institute of Medicine, 2008. Assessment of the Role of Intermittent Preventive Treatment for Malaria in Infants. Washington, DC: Institute of Medicine.
  18. Leroy JL, Habicht JP, Pelto G, Bertozzi SM, , 2007. Current priorities in health research funding and lack of impact on the number of child deaths per year. Am J Public Health 97: 219223.[Crossref]
  19. UNICEF, 2007. The State of the World's Children 2008. New York: UNICEF.
  20. Armstrong Schellenberg JR, Mrisho M, Manzi F, Shirima K, Mbuya C, Mushi AK, Ketende SC, Alonso PL, Mshinda H, Tanner M, Schellenberg D, , 2008. Health and survival of young children in southern Tanzania. BMC Public Health 8: 194.[Crossref]
  21. Mrisho M, Schellenberg JA, Mushi AK, Obrist B, Mshinda H, Tanner M, Schellenberg D, , 2007. Factors affecting home delivery in rural Tanzania. Trop Med Int Health 12: 862872.[Crossref]
  22. Hayes RJ, Moulton LH, , 2009. Cluster Randomised Trials. Boca Ranton, FL: Taylor & Francis.[Crossref]
  23. Manzi F, Schellenberg J, Hamis Y, Mushi AK, Shirima K, Mwita A, Simba A, Rusibamayila N, Kitambi M, Tanner M, Alonso P, Mshinda H, Schellenberg D, , 2009. Intermittent preventive treatment for malaria and anaemia control in Tanzanian infants: the development and implementation of a public health strategy. Trans R Soc Trop Med Hyg 103: 7986.[Crossref]
  24. Mushi AK, Schellenberg J, Mrisho M, Manzi F, Mbuya C, Mponda H, Mshinda H, Tanner M, Alonso P, Pool R, Schellenberg D, , 2008. Development of behaviour change communication strategy for a vaccination-linked malaria control tool in southern Tanzania. Malar J 7: 191.[Crossref]
  25. Shirima K, Mukasa O, Schellenberg JA, Manzi F, John D, Mushi A, Mrisho M, Tanner M, Mshinda H, Schellenberg D, , 2007. The use of personal digital assistants for data entry at the point of collection in a large household survey in southern Tanzania. Emerg Themes Epidemiol 4: 5.[Crossref]
  26. Murray CJL, Shengelia B, Gupta N, Moussavi S, Tandon A, Thieren M, , 2003. Validity of reported vaccination coverage in 45 countries. Lancet 362: 10221027.[Crossref]
  27. Filmer D, Pritchett LH, , 2001. Estimating wealth effects without expenditure data–or tears: an application to educational enrollments in states of India. Demography 38: 115132.
  28. Guthmann JP, Ruiz A, Priotto G, Kiguli J, Bonte L, Legros D, , 2002. Validity, reliability and ease of use in the field of five rapid tests for the diagnosis of Plasmodium falciparum malaria in Uganda. Trans R Soc Trop Med Hyg 96: 254257.[Crossref]
  29. Huong NM, Davis TME, Hewitt S, Van Huong N, Uyen TT, Nhan DH, Cong LD, , 2002. Comparison of three antigen detection methods for diagnosis and therapeutic monitoring of malaria: a field study from southern Vietnam. Trop Med Int Health 7: 304308.[Crossref]
  30. Swarthout TD, Counihan H, Senga RKK, van den Broek I, , 2007. Paracheck-Pf accuracy and recently treated Plasmodium falciparum infections: is there a risk of over-diagnosis? Malar J 6: 58.[Crossref]
  31. Ceesay SJ, Casals-Pascual C, Erskine J, Anya SE, Duah NO, Fulford AJC, Sesay SSS, Abubakar I, Dunyo S, Sey O, Palmer A, Fofana M, Corrah T, Bojang KA, Whittle HC, Greenwood BM, Conway DJ, , 2008. Changes in malaria indices between 1999 and 2007 in The Gambia: a retrospective analysis. Lancet 372: 15451554.[Crossref]
  32. O'Meara WP, Bejon P, Mwangi TW, Okiro EA, Peshu N, Snow RW, Newton C, Marsh K, , 2008. Effect of a fall in malaria transmission on morbidity and mortality in Kilifi, Kenya. Lancet 372: 15551562.[Crossref]
  33. Schellenberg D, Menendez C, Aponte J, Guinovart C, Mshinda H, Tanner M, Alonso P, , 2004. The changing epidemiology of malaria in Ifakara Town, southern Tanzania. Trop Med Int Health 9: 6876.[Crossref]

Data & Media loading...

  • Received : 22 Apr 2009
  • Accepted : 04 Dec 2009

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error