Effect of repeated anthelminthic treatment on malaria in school children in Kenya: a randomized, open label, equivalence trial.


Kepha, S; Nuwaha, F; Nikolay, B; Gichuki, P; Mwandawiro, CS; Mwinzi, PN; Odiere, MR; Edwards, T; Allen, E; Brooker, SJ; (2016) Effect of repeated anthelminthic treatment on malaria in school children in Kenya: a randomized, open label, equivalence trial. The Journal of infectious diseases, 213 (2). pp. 266-75. ISSN 0022-1899 DOI: 10.1093/infdis/jiv382

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Abstract

BACKGROUND: School children living in the tropics are often concurrently infected with plasmodium and helminth parasites. It has been hypothesized that immune responses evoked by helminths may modify malaria-specific immune responses and increase the risk of malaria.<br/> METHODS: We performed a randomized, open-label, equivalence trial among 2436 school children in western Kenya. Eligible children were randomized to receive either 4 repeated doses or a single dose of albendazole and were followed up during 13 months to assess the incidence of clinical malaria. Secondary outcomes were Plasmodium prevalence and density, assessed by repeat cross-sectional surveys over 15 months. Analysis was conducted on an intention-to-treat basis with a prespecified equivalence range of 20%.<br/> RESULTS: During 13 months of follow-up, the incidence rate of malaria was 0.27 episodes/person-year in the repeated treatment group and 0.26 episodes/person-year in the annual treatment group (incidence difference, 0.01; 95% confidence interval, -.03 to .06). The prevalence and density of malaria parasitemia did not differ by treatment group at any of the cross-sectional surveys.<br/> CONCLUSIONS: Our findings suggest that repeated deworming does not alter risks of clinical malaria or malaria parasitemia among school children and that school-based deworming in Africa may have no adverse consequences for malaria.<br/> CLINICAL TRIALS REGISTRATION: NCT01658774.<br/>

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Medical Statistics
Faculty of Infectious and Tropical Diseases > Dept of Clinical Research
Research Centre: Neglected Tropical Diseases Network
PubMed ID: 26170395
URI: http://researchonline.lshtm.ac.uk/id/eprint/2293265

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