a systematic review and meta-analysis of the efficacy and safety of intermittent preventive treatment of malaria in children (iptc)疗效和安全性的系统回顾和荟萃分析间歇性预防治疗疟疾的儿童(iptc).pdfVIP

A Systematic Review and Meta-Analysis of the Efficacy and Safety of Intermittent Preventive Treatment of Malaria in Children (IPTc) Anne L. Wilson*, on behalf of the IPTc Taskforce London School of Hygiene and Tropical Medicine, London, United Kingdom Abstract Background: Intermittent preventive treatment of malaria in children less than five years of age (IPTc) has been investigated as a measure to control the burden of malaria in the Sahel and sub-Sahelian areas of Africa where malaria transmission is markedly seasonal. Methods and Findings: IPTc studies were identified using a systematic literature search. Meta-analysis was used to assess the protective efficacy of IPTc against clinical episodes of falciparum malaria. The impact of IPTc on all-cause mortality, hospital admissions, severe malaria and the prevalence of parasitaemia and anaemia was investigated. Three aspects of safety were also assessed: adverse reactions to study drugs, development of drug resistance and loss of immunity to malaria. Twelve IPTc studies were identified: seven controlled and five non-controlled trials. Controlled studies demonstrated protective efficacies against clinical malaria of between 31% and 93% and meta-analysis gave an overall protective efficacy of monthly administered IPTc of 82% (95%CI 75%–87%) during the malaria transmission season. Pooling results from twelve studies demonstrated a protective effect of IPTc against all-cause mortality of 57% (95%CI 24%–76%) during the malaria transmission season. No serious adverse events attributable to the drugs used for IPTc were observed in any of the studies. Data from three studies that followed children during the malaria transmission season in the year following IPTc administration showed evidence of a slight increas