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Analysis of the effects of malaria chemoprophylaxis in children on haematological responses, morbidity and mortality

Prinsen Geerligs, P. D., Brabin, Bernard and Eggelte, T. A. (2003) 'Analysis of the effects of malaria chemoprophylaxis in children on haematological responses, morbidity and mortality'. Bulletin of the World Health Organization, Vol 81, Issue 3, pp. 205-216.

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Abstract

This paper reviews the evidence for beneficial effects of malaria chemoprophylaxis on haematological responses, morbidity, mortality, health service utilization and rebound immunity in children. As anaemia may play an important role in childhood mortality, it is important to assess evidence from controlled trials of the potential of cl emoprophylaxis to reduce childhood anaemia. An analysis of trials found good evidence that malaria chemoprophylaxis improves mean haemoglobin levels and reduces severe anaemia, clinical malaria attacks, parasite and spleen rates. Significant reductions in outpatient attendance and hospital admissions have been achieved, and substantial evidence from Gambian studies shows reductions in mortality. Chemoprophylaxis in children does not seem to produce any sustained impairment of immunity to malaria, although rebound effects may be greater in children who receive prophylaxis during infancy. Short periods of targeted prophylaxis are likely to be preferable to continuous drug administration. Evidence of the protective efficacy of malaria chemoprophylaxis in children shows that this strategy could be considered within integrated health programmes for specific time periods. Intermittent routine combination therapy early in childhood may be appropriate for those living under holoendemic conditions. Large-scale studies over a number of years are needed to address this issue and the impact of this approach on health service utilization, mortality, and the emergence of drug-resistant parasites.

Item Type: Article
Subjects: QV Pharmacology > Anti-Inflammatory Agents. Anti-Infective Agents. Antineoplastic Agents > QV 256 Antimalarials
QV Pharmacology > Drug Standardization. Pharmacognosy. Medicinal Plants > QV 771 Standardization and evaluation of drugs
QX Parasitology > Protozoa > QX 135 Plasmodia
WA Public Health > Statistics. Surveys > WA 900 Public health statistics
WA Public Health > Statistics. Surveys > WA 950 Theory or methods of medical statistics. Epidemiologic methods
WB Practice of Medicine > Therapeutics > WB 330 Drug therapy
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 770 Therapy
WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 155 Anemia
WS Pediatrics > Diseases of Children and Adolescents > By System > WS 300 Hemic and lymphatic system
WS Pediatrics > By Age Groups > WS 430 Infancy
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Depositing User: Martin Chapman
Date Deposited: 20 Jun 2013 14:17
Last Modified: 06 Feb 2018 13:04
URI: http://archive.lstmed.ac.uk/id/eprint/2548

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