Programme to combat malaria - IPTi ICARIA

IPTi (Intermittent Preventive Treatment in Infants)
ICARIA (Improving Care through Azithromycin research for Infants in Africa)

Improving child health through optimising health systems efficiency.

  • INTRODUCTION

    Half of the 5.4 million children under 5 years of age (U5) who die in the world annually live in the African region where falciparum malaria is a major cause of death.

    Intermittent preventive treatment of malaria in infants (IPTi), consisting of the administration of sulphadoxine-pyrimethamine to infants, is a safe, efficacious and cost-effective intervention in reducing malaria.

    Despite the WHO recommendation (2010) to administer IPTi alongside routine vaccinations in areas of high to moderate perennial transmission, IPTi is not implemented in most of African malaria endemic countries.

    Recent studies in some African countries showed that azithromycin (AZi)– is associated with a significant reduction in child mortality when used for mass drug administration in the elimination of trachoma.

    Evaluation of the impact on mortality reduction of the addition of AZi to IPTi (ITPi+) and assessment of bottlenecks for IPTi scale-up are needed before promoting their large scale-up.

  • GOALS

    Overall goals:

    • To evaluate the impact of azithromycin administered through the Expanded Program on Immunization in addition to IPTi-SP on all-cause mortality at 18 months of age in Sierra Leone.

     

    Specific goals:

    • To evaluate the impact of azithromycin, plus intermittent preventive treatment with sulphadoxine-pyrimethamine administered through the Expanded Program on Immunisation on all-cause mortality at 18 months of age in young children living in areas of high mortality and malaria burden in Sub-Saharan Africa.

    • To identify implementation bottlenecks for intermittent preventive treatment with sulphadoxine-pyrimethamine administered through the Expanded Program on Immunisation scale-up in Sierra Leone.

  • WHAT WE DO

     

    An individually randomized, placebo-controlled trial of IPTi in addition to AZi will be conducted in 20,560 infants exposed to a high malaria endemicity and mortality burden in Sierra Leone.

    This approach will allow to obtain conclusive evidence of the effect of IPTi together with AZi in reducing mortality of children under 5 years of age and will address knowledge and implementation gaps to expand ITPi / IPTi +.

    ISGlobal leads a consortium that includes the College of Medicine and Allied Health Sciences (COMAHS)/Ministry of Health and Sanitation Sierra Leone (MoHS), the Hospital Clínic Barcelona -that will lead the evaluation of resistance to macrolides- and the Hospital Sant Joan de Déu (HSJD), that will coordinate the Safety Monitoring component.

    This programme has also been awarded a grant by the Bill and Melinda Gates Foundation.

  • WHERE

    In 15 primary care centers in the districts of Bombali, Port Loko and Tonkolili in Sierra Leone.

  • MORE INFORMATION