This is an individually randomized, controlled, single blind three arm clinical trial of malaria chemoprevention strategies Arm 1: Intermittent screening and treatment (IST) - students will receive treatment if they have a positive high sensitivity rapid diagnostic test (RDT). Arm 2: Intermittent preventive treatment (IPT) - all students will receive treatment. Arm 3: Control - students will receive standard of care (no preventive treatment). Outcomes include P. falciparum infection and parasite density, gametocyte carriage and gametocyte density, anemia, cognitive function and educational testing, as well as infection prevalence in student's households to assess the impact on transmission.
Students will be enrolled in a single primary school in Machinga District, Malawi. The intervention will be conducted every 6-weeks during the two school terms which coincide with peak malaria transmission. Students in the IPT are and those that test positive in the IST arm will be treatment with dihydroartemisinin-piperaquine (DP) (females less than 10 years old and all males) or chloroquine (females 10 years old or older).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
SINGLE
Enrollment
746
Treatment of females less than 10 years old and all males in Arm 2 and those who test positive in Arm 1.
Treatment of females 10 years old and older in Arm 2 and those who test positive in Arm 1.
Kamuzu University of Health Sciences
Blantyre, Malawi
P. falciparum infection
detected by polymerase chain reaction (PCR, binary)
Time frame: 6-8 weeks after the last intervention
P. falciparum gametocyte carriage
detected by q-rtPCR (binary)
Time frame: 6-8 weeks after the last intervention
Number of participant with anemia
World Health Organization age-sex definitions (binary)
Time frame: 6-8 weeks after the last intervention
Mean hemoglobin concentration
g/dL (continuous)
Time frame: 6-8 weeks after the last intervention
Total parasite density
log transformed (continuous)
Time frame: 6-8 weeks after the last intervention
Gametocyte density
log transformed (continuous)
Time frame: 6-8 weeks after the last intervention
Rate of clinical malaria
cumulative incidence
Time frame: from the first intervention to 6-8 weeks after the last intervention
P. falciparum prevalence among household members
detected by PCR
Time frame: 6-8 weeks after the last intervention
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