Intermittent preventive treatment against malaria: an update

Abstract

Intermittent preventive treatment (IPT) against malaria is a malaria control strategy aimed at reducing the burden of malaria in certain high-risk groups, namely pregnant women and children. Three strategies – IPT in pregnancy (IPTp), infants (IPTi) and children (IPTc) – are reviewed here focusing on the mechanism of action, choice of drugs available, controversies and future research. Drugs for IPT need to be co-formulated, long acting, safe and preferably administered as a single dose. There is no obvious replacement for sulfadoxine–pyrimethamine, the most commonly utilized drug combination. All strategies face similar problems of rising drug resistance, falling malaria transmission and a policy shift from controlling disease to malaria elimination and eradication. IPT is an accepted form of malaria control, but to date only IPTp has been adopted as policy.

Keywords::

• anemia
• children
• infants
• intermittent preventive therapy
• malaria
• pregnancy
• school children
• seasonal

Financial & competing interests disclosure

Roly D Gosling and Daniel Chandramohan are salaried by their institutions, Matthew E Cairns is funded by the MRC UK and R Matthew Chico is funded from a grant from Pfizer on a trial of azithromycin and chloroquine for malaria in pregnancy. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.