Intermittent Preventive Treatment in Infants - IPTi
Swiss Tropical Institute London School of Hygiene and Tropical Medicine

IPTi Decision-support tool

IPTi Decision-Support Tool

Introduction

What is Intermittent Preventive Treatment?

Intermittent Preventive Treatment (IPT) involves treatment with an antimalarial drug irrespective of whether or not the recipient has symptomatic malaria. IPT is currently used in many countries as an intervention to reduce malaria in pregnant women (IPTp), and there is a growing interest in its use for infants (IPTi) and young children (IPTc).

How effective is IPT in infants?

The IPTi Consortium has conducted a pooled analysis of data from six double-blind, randomised, placebo-controlled trials [1]. This analysis found that across the trials, IPTi with sulphadoxine-pyrimethamine (SP) reduced clinical malaria by 30% (95% confidence interval (CI): 20%, 39%), hospital admissions with malaria parasites by 38% (95% CI: 13%, 56%), all-cause hospitalizations by 23% (95% CI: 10%, 34%) and the risk of anaemia by 21% (95% CI: 8%, 32%) in the first year of life.

What is the aim of this decision-support tool?

This interactive tool is intended to aid national and sub-national policy makers in assessing whether IPTi is a locally appropriate intervention, by providing relevant information to support IPTi-related policy discussions. The tool is restricted to sub-Saharan Africa countries that have endemic transmission of Plasmodium falciparum malaria.

To identify whether a malaria control intervention that targets infants is appropriate, it is important to understand which age groups suffer the greatest malaria morbidity and mortality burden. In areas with high malaria transmission the greatest burden falls on the youngest age groups, while in areas with less intense transmission the malaria burden falls increasingly on older children. This has implications for national malaria control programmes, which want to have maximum impact on illness and death attributable to malaria and so need to target interventions towards the most appropriate age groups.

The tool provides:

  1. A graph of the age pattern of malaria morbidity and mortality for a given sub-national administrative area, and an estimate of the proportion of infants that would be targeted by IPTi. There are six possible malaria age-patterns, based on the expected transmission intensity and seasonality for that setting.
  2. The number of cases averted for each of these transmission settings adjusted for the level of sulphadoxine-pyrimethamine (SP) drug-resistance and the coverage of IPTi.
  3. The cost-effectiveness of introducing IPTi, using estimated local costs.

Other important factors, such as other interventions used as part of the National Malaria Control Programme, will also need to be considered when making a policy decision.

Next: Data and interpretation

Last updated on 2011-07-06