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Antimalarial prophylaxis did not reduce mortality, hospital admission in anemic children
Intermittent preventive antimalarial treatment modestly improved hemoglobin levels in children with anemia, but it did not significantly reduce mortality or hospital admissions, according to recent findings.
“Children living in malaria areas may develop severe anemia, often caused by malaria infection, and this can cause death if not treated properly,” researcher Mwaka Athuman, PhD, of the Ifakara Health Institute in Tanzania, and colleagues wrote. “Intermittent preventive treatment is a course of malaria treatment given regularly to these children in order to prevent infection and malaria illness.”
To evaluate the effect of intermittent therapy on children in malaria-endemic areas, Athuman and colleagues performed a review of all randomized controlled trials pertaining to the treatment of anemic children. The researchers identified six trials for inclusion with 3,847 participants: three trials were conducted in areas of low malaria endemicity, and three were conducted in regions with moderate to high endemicity.
Two trials also included the administration of iron supplements to all children as a treatment for anemia, and two additional trials evaluated the use of iron in a factorial analysis.
In follow-up to three trials (n=3,160), the researchers found that intermittent preventive treatment of children with anemia had little to no effect on mortality or hospital admission at 6 months (RR=0.9; 95%CI, 0.71-1.13). Subgroup analyses showed no difference between children who received iron supplements and those who did not.
Intermittent preventive treatment in anemic children likely had little to no effect on the percentage of children anemic at 12 weeks. However, findings from four trials suggested that the therapy likely increased the mean change in hemoglobin from baseline to 12-week follow-up by 0.32 g/dL (mean difference=0.32; 95% CI, 0.19-0.45).
These results also suggested that intermittent preventive treatment may improve hemoglobin levels at 12 weeks (MD=0.35; 95% CI, 0.06-0.64). Subgroup analyses did not reflect a difference in either of these outcomes between children who received iron and those who did not.
“While we did note small benefits in hemoglobin levels when treating anemic children with intermittent preventive treatment, there was no detectable effect on the number of deaths or hospital admissions,” Athuman said in a press release. “The summary of the evidence will assist people forming policy guidance as to whether intermittent preventive treatment is worthwhile, and provide a basis for researchers to consider whether additional studies are needed.”
Disclosure: The researchers report no relevant financial disclosures.
