Effect of intermittent treatment with amodiaquine on anaemia and malarial fevers in infants in Tanzania: a randomised placebo-controlled trial

Massaga, Julius J.; Kitua, Andrew Y; Lemnge, Martha; Akida, Jumaa A; Malle, Lincoln; Rønn, Anita M.; Theander, Thor G.; Bygbjerg, Ib Christian

doi:10.1016/s0140-6736(03)13504-0

Cited by 126 publications

(92 citation statements)

References 24 publications

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“…Therefore, we conducted a hospital based open-label randomised clinical trial to evaluate safety, tolerability and efficacy of AQ in semi-immune indigenous adult healthy volunteers with and without Plasmodium falciparum infection in Tanzania. These results were valuable before a study of preventive intermittent treatment with AQ in infants (Massaga et al, 2003).…”

Section: Introductionmentioning

confidence: 90%

Biological and haematological safety profile of oral amodiaquine and chloroquine in healthy volunteers with or without <i>Plasmodium falciparum</i> infection in northeast Tanzania

Massaga

Lusingu²,

Makunde³

et al. 2008

Tanzania J Hlth Res

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Amodiaquine (AQ), an effective antimalarial drug for uncomplicated malaria, has been greatly restricted after cases of life-threatening agranulocytosis and hepatic toxicity during prophylactic use. We conducted a hospital based open-label randomised clinical trial in 40 indigenous semi-immune healthy adult male volunteers with and without malaria parasites. The objective was to collect data on biological and haematological safety, tolerability, and parasitological efficacy to serve as baseline in the evaluation of the effectiveness of AQ preventive intermittent treatment against malaria morbidity in infants. Volunteers were stratified according to parasitaemia status and randomly assigned 20 participants each arm to three days treatment with either AQ or chloroquine (CQ). The level of difference of selected haematological and hepatological values pre-and post-trial were marginal and within the normal limits. Clinical adverse effects mostly mild and transient were noticed in 33.3% CQ treated-aparasitaemic, 23.8% of CQ treated-parasitaemic, 28.6% of AQ-treated parasitaemic and 14.3% of aparasitaemic receiving AQ. Amodiaquine attained 100% parasitological clearance rate versus 70% in CQ-treated volunteers. The findings indicate that there was no agranulocytosis or hepatic toxicity suggesting that AQ may pose no public health risk in its wide therapeutic dosage uses. Larger studies are needed to exclude rare adverse effects. _________________________________________________________________________________________

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Section: Introductionmentioning

confidence: 90%

Biological and haematological safety profile of oral amodiaquine and chloroquine in healthy volunteers with or without <i>Plasmodium falciparum</i> infection in northeast Tanzania

Massaga

Lusingu²,

Makunde³

et al. 2008

Tanzania J Hlth Res

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“…After two efficacy studies in Tanzania reported 59% 5 and 65% 6 reductions in clinical malaria episodes, a group of researchers, funders, and policy makers agreed a research agenda to generate the evidence needed for this intervention to be considered for policy and practice. The group was partly motivated by delays of many years between first evidence of impact and decisions on policy and scale-up: for ITNs, this was 10 years.…”

Section: Introductionmentioning

confidence: 99%

Community Effectiveness of Intermittent Preventive Treatment for Infants (IPTi) in Rural Southern Tanzania

Schellenberg¹,

Shirima²,

Maokola³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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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 (P = 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 (P = 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.

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“…The challenge of making the preventive programs respond to science, which has been discussed recently in relation to malaria in pregnancy, 1 is equally applicable to all malaria interventions. Indeed, preventive measures such as indoor residual spraying, intermittent preventive treatment in pregnancy, and insecticide-treated nets (ITNs) have been available for quite some time, and new approaches 2-4 such as anemia prevention using intermittent preventive treatment 5,6 are under evaluation. Yet it is clear that sufficient money is a stumbling block, since malaria endemic countries are too poor to be able to solve the problem alone.…”

Section: Aims Of the Training Component Of The Gates Malaria Partnershipmentioning

confidence: 99%

Enhancing the Application of Effective Malaria Interventions in Africa Through Training

Ijumba

Kitua

2004

The American Journal of Tropical Medicine and Hygiene

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Abstract. Africa bears more than 90% of the entire global malaria disease burden. Surprisingly, even with the current renewed interest in malaria prevention and control and the enabling environment resulting from the Roll Back Malaria initiative and the political commitment made by the African Presidents at the Abuja Summit, there are still no significant initiatives for strengthening capacity for malaria control through training within the African continent itself. The Center for Enhancement of Effective Malaria Interventions (CEEMI) has been established in Dar es Salaam, Tanzania for results-oriented training. It is intended to provide the needed skills for identifying and solving malaria control problems and providing incentives to malaria control workers in their work performance. The intention is to produce implementers with leadership skills for planning and managing malaria control activities and who can use strategic thinking in improving their work performance. To sustain political commitment and support and to sensitize the community on malaria issues, the CEEMI, in collaboration with the Ministry of Health (National Malaria Control Program), the Institute of Journalism and Mass Communication of the University of Dar es Salaam, and the Commonwealth Broadcasting Association have already conducted malaria seminars for Tanzanian Members of Parliament and journalists from Kenya, Malawi, Tanzania, and Uganda. Additionally, a diploma course in health communication is being developed for journalists and for the same purpose. Also being developed is a training module for "Council Malaria Focal Person." This is aimed at complementing the Roll Back Malaria initiative to meet the Abuja targets of reducing morbidity and mortality due to malaria by 50% by 2010. BACKGROUND AND RATIONALE

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Effect of intermittent treatment with amodiaquine on anaemia and malarial fevers in infants in Tanzania: a randomised placebo-controlled trial

Cited by 126 publications

References 24 publications

Biological and haematological safety profile of oral amodiaquine and chloroquine in healthy volunteers with or without <i>Plasmodium falciparum</i> infection in northeast Tanzania

Biological and haematological safety profile of oral amodiaquine and chloroquine in healthy volunteers with or without <i>Plasmodium falciparum</i> infection in northeast Tanzania

Community Effectiveness of Intermittent Preventive Treatment for Infants (IPTi) in Rural Southern Tanzania

Enhancing the Application of Effective Malaria Interventions in Africa Through Training

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