Severe anaemia is a frequent cause of admission to hospitals in tropical Africa and about 10%
of such children die. In endemic countries, anaemia has multiple causes such as nutritional
deficiencies, infections and haemoglobinopathies. However, Plasmodium falciparum infection is
believed to be the major contributory factor to the aetiology of severe anaemia. Severe
anaemia is usually treated by blood transfusion although transfusion carries the attendant
risk of transmission of HIV and other blood-borne infections. Thus, there is a need to
explore novel strategies to reduce the incidence of severe anaemia in high-risk groups such
as children with suboptimal haemoglobin levels because these children are at increased risk
of developing severe anaemia if they develop a malaria infection before their haemoglobin
level has normalized. Therefore, it is proposed to study whether monthly chemoprophylaxis
with sulphadoxine/pyrimethamine (S/P) given during malaria transmission season can protect
Gambian children from developing severe anaemia. After receiving treatment from the hospital,
1200 children admitted to the hospital with a haematocrit of less than 21% were randomised to
receive either monthly S/P or placebo during the rest of the malaria transmission season.
Morbidity was monitored throughout the rainy season. Study subjects were seen at the end of
the dry season to document morbidity and mortality.
Phase:
Phase 3
Details
Lead Sponsor:
Gates Malaria Partnership London School of Hygiene and Tropical Medicine
Collaborators:
Department of State for Health and Social Welfare, The Gambia London School of Hygiene and Tropical Medicine
Treatments:
Fanasil, pyrimethamine drug combination Pyrimethamine Sulfadoxine