IPTi has been investigated in 8 double-blinded randomised-controlled clinical trials in Tanzania, Ghana, Mozambique, Kenya and Gabon, and is being implemented on a pilot basis by UNICEF in Ghana, Malawi, Madagascar, Benin, Mali and Senegal.
IPTi is being investigated in Papua New Guinea and results are expected in mid 2010.
For further information contact:
Àlex Argemí, IDIBAPS - Hospital Clínic Scientific, +34 93 227 57 00
Emma Griffiths, Weber Shandwick, +44 20 7067 0230
Malaria Control Method Could Prevent 6 million New Infant Cases
The Lancet publishes new findings showing 30% reduction in babies under 12 months using a
WHO-recommended approach, but few African countries have adopted it
BARCELONA, 17 September 2009 — A third (30%) of malaria cases can be avoided in African
infants using a safe, affordable and simple tool called Intermittent Preventive Treatment of malaria in
Infants (IPTi) with the medicine sulphadoxine-pyrimethamine (SP), which can be delivered alongside
existing childhood vaccination programmes.i Results of a meta-analysis examining six clinical trials in
Africa for the malaria intervention which the World Health Organization already recommends are
published online today in the medical journal, The Lancet. Research experts say if IPTi-SP were
expanded in other African countries, 6 million cases of malaria could be prevented each year in those
most vulnerable to the disease.ii,iii
“These results confirm the potential for IPTi using SP, which can be easily and rapidly implemented
via existing WHO immunisation programmes, saving tens of thousands of lives every year across
Africa,” commented Dr Pedro Alonso, a principal investigator, head of the Secretariat of the IPTi
Consortium, associated with University of Barcelona, Spain. “IPTi provides a valuable addition to
efforts to fight malaria and so international policy-makers and heads of national Malaria Control
Programmes should consider its immediate adoption and integration into existing programmes,” he
added.
Organised by the IPTi Consortium and supporting partners – a unique collaboration of more than 20
organisations in Africa, Europe and the United States – the pooled analysis of six randomised,
placebo-controlled trials of IPTi-SP in Africa provides the best evidence to date that this approach is
effective in preventing malaria in infants. The study analysed results from nearly 8,000 infants, in four
African countries, over nine years, between 1999-2008. The efficacy results were re-analysed by the
statistician of each of the six trials, and an independent panel made up of experts in safety and
pharmacovigilance in Africa conducted an analysis of the safety. The IPTi Consortium is supported by
the Bill & Melinda Gates Foundation.
UNICEF’s Operational Research Coordinator, Dr Alexandra de Sousa, stated “UNICEF supports IPTi
implementation scale up in Africa, a new intervention in the control of malaria with the potential to
significantly reduce child illness”.
A separate study in Northern Tanzania shows that in areas of very high resistance to the medication,
IPTi with SP is not efficacious and alternative anti-malarial drugs are needed. The long-acting
medicine mefloquine was seen to reduce the incidence of clinical malaria in infants in the first year of
life by 38%.iv For the long term, it is important that research is accelerated to develop additional drugs
for use with IPTi in different settings and in different circumstances, especially in areas where parasite
resistance is a problem.
Malaria represents an important public health burden in Africa, disproportionately affecting the
youngest and most vulnerable. Of the 247 million cases of malaria worldwide in 2006, 86% occurred
in Africa.ii African infants are most at risk of the worst forms of malaria, every 30 seconds an African
child dies from malaria.v
# # #
Notes to Editor
About IPTi
IPTi is the administration of an anti-malarial tablet to infants, two or three times in the first year of life,
deliverable alongside established vaccination programmes such as WHO’s Expanded Programme for
Immunisation. It is inexpensive (each dose costs between USD $0.13 - $0.23)vivii and cost effective.
IPTi with SP has been reviewed by a committee of the US National Academy of Sciences’ Institute of
Medicine and the World Health Organization’s Technical Expert Group – these committees
recommend that it should be considered for implementation in areas of moderate to high levels of
malaria transmission and low to moderate levels of parasite resistance to SP.viii,ix
About the trials in the pooled analysis
Trials were conducted in Mozambique, Gabon, Tanzania and Ghana involving the following
organisations in Africa and Europe: Barcelona Centre for International Health Research, Spain;
Centro de Investigação em Saude de Manhiça, Mozambique; University of Tübingen, Germany;
Ifakara Health Research Development Centre, Tanzania; University of Witwatersrand, Johannesburg,
South Africa; Institute of Tropical Medicine and International Health, Charité, University Medicine
Berlin, Germany; Kintampo Health Research Centre, Ghana Health Service/Ministry of Health,
Ghana; London School of Hygiene and Tropical Medicine, London, UK; Albert Schweitzer Hospital,
Lambaréné, Gabon; Ministry of Health/Ghana Health Service; Bernhard Nocht Institute for Tropical
Medicine, Hamburg, Germany; Swiss Tropical Institute, Basel, Switzerland.
About the trial in Northern Tanzania
The trial was conducted in two sites in northern Tanzania, Korgewe and Same, by the following
organisations; Department of Infectious and Tropical Diseases, London School of Hygiene and
Tropical Medicine, London, UK; the National Institute for Medical Research, Tanga Centre, Tanga,
Tanzania; and the Kilimanjaro Christian Medical College, Moshi, Tanzania.
About the IPTi Consortium
The IPTi Consortium's Secretariat was the Barcelona Centre for International Health Research,
Hospital Clinic, University of Barcelona, headed by Dr Pedro L. Alonso. The IPTi Consortium consists
of leading centres of malaria research in Africa, Europe, United States and Papua New Guinea
including the Albert Schweitzer Hospital, Lambaréné, Gabon; Barcelona Centre for International
Health Research, Hospital Clinic, University of Barcelona, Spain; Case Western Reserve University,
Cleveland, USA; Centers for Disease Control and Prevention, Atlanta, USA; Ifakara Health Research
and Development Centre, Ifakara, Tanzania; Institut de Recherche pour le Développement, Dakar,
Sénégal; Kenya Medical Research Institute, Kisumu, Kenya; Kilimanjaro Christian Medical Centre,
Moshi, Tanzania; London School of Hygiene and Tropical Medicine, London, UK; Manhiça Health
Research Centre, Manhiça, Mozambique; National Institute for Medical Research, Amani, Tanzania;
PNG Institute of Medical Research, Goroka, Papua New Guinea; Swiss Tropical Institute, Basel,
Switzerland; Université Cheikh Anta Diop de Dakar, Dakar, Sénégal; University of Copenhagen,
Copenhagen, Denmark; University of Tübingen, Tübingen, Germany; Walter and Eliza Hall Institute of
Medical Research, University of Melbourne, Australia; World Health Organization (WHO); United
Nations Children's Fund (UNICEF).
i Aponte John J, Schellenberg David, Egan Andrea, et al. Efficacy and safety of intermittent
preventive treatment with sulfadoxine-pyrimethamine for malaria in African infants: a pooled analysis
of six randomised, placebo-controlled trials. Lancet (To be published 17 September 2009)
ii WHO. World Malaria Report 2008. World Health Organisation, Geneva Switzerland, 2008.
iii Based on calculations from 212 million cases of malaria in Africa provided by the World Malaria
Report 2008 (ref ii), of which about 10% are episodes in infants provided by Professor Tom Smith, at
the Swiss Tropical Institute and of which 30 % of cases could be averted by IPTi provided by the
research paper on Efficacy and safety of intermittent preventive treatment with sulfadoxinepyrimethamine
for malaria in African infants: a pooled analysis of six randomised, placebo-controlled
trials (ref i)
iv Gosling Roly D, Gesase Samwel, Mosha Jacklin F, et al. Protective efficacy and safety of three
antimalarial regimens for intermittent preventive treatment for malaria in infants: a randomised,
placebo-controlled trial. Lancet (To be published 17 September 2009)
v 10 Facts on Malaria.World Health Organisation, March 2009. (http://www.who.int/features/
factfiles/malaria/en/index.html, accessed 7 September 2009)
vi Hutton Guy, Schellenberg, David, Tediosi Fabrizio, et al. Cost-effectiveness of malaria intermittent
preventive treatment in infants (IPTi) in Mozambique and the United Republic of Tanzania. Bull
World Health Organ 2009;87:123–129
vii Manzi Fatuma, Hutton Guy, Schellenberg Joanna, et al. From strategy development to routine
implementation: the cost of Intermittent Preventive Treatment in Infants for malaria control. BMC
Health Services Research 2008, 8:165
viii WHO. Report of the Technical Consultation on Intermittent Preventive Treatment in Infants (IPTi),
Technical Expert Group on Preventive Chemotherapy, 23-24 April 2009 – World Health
Organisation, Geneva, Switzerland, Room D46025, 2009.
ix Assessment of the Role of Intermittent Preventive Treatment for Malaria in Infants: Letter Report. US
National Academy of Science, 2008. (http://www.nap.edu/catalog.php?record_id=12180, accessed
7 September)
Press release for the medical and scientific community
"Meta-Analysis Demonstrates that Intermittent Preventive Treatment in Infants with Sulfadoxine-Pyrimethamine Reduces Malaria Episodes by 30%"
Results published in The Lancet extend earlier findings on safety and efficacy of novel malaria control tool
"Meta-Analysis Demonstrates that Intermittent Preventive Treatment in Infants with Sulfadoxine-Pyrimethamine Reduces Malaria Episodes by 30%"
Results published in The Lancet extend earlier findings on safety and efficacy of novel malaria control tool
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