Staedke SG, et al. - A cluster-randomised controlled trial was performed to evaluate the impact of intermittent preventive treatment (IPT) of primary schoolchildren with dihydroartemisinin-piperaquine (DP) on indicators of malaria transmission in the community, in Jinja, Uganda. Results of this study suggested that IPT of schoolchildren with DP could have a positive effect on community-level malaria indicators and be operationally feasible.

Methods

• Eighty-four clusters were included, each involving one primary school and the 100 closest available households.  
• To ensure balance by geography and school type, the clusters were randomly assigned 1:1 to receive IPT with DP or standard care (control) by restricted randomisation.
• For up to six rounds (June to December, 2014), children in intervention schools received IPT monthly.
• Cross-sectional community surveys was performed in randomly selected households at baseline and in January to April, 2015, during which they measured participants' temperatures and obtained finger-prick blood smears for measurement of parasite prevalence by microscopy.
• In addition, entomological surveys 1 night per month was performed in households from 20 randomly selected IPT and 20 control clusters.
• Parasite prevalence in the final community survey was the primary trial outcome.
• The annual entomological inoculation rate (aEIR) from July, 2014, to April, 2015 was the primary entomological survey outcome.

Results

• As per data, among twenty-three thousand, two hundred eighty students registered in the 42 intervention schools, 10,079 (43%) aged 5–20 years were involved and received at least one dose of DP.
• Data reported that 9,286 (92%) of 10,079 received at least one full course of DP (three doses).
• Findings revealed that community-level parasite prevalence was lower in the intervention clusters than in the control clusters (19% vs 23%, adjusted risk ratio 0·85, 95% CI 0·73–1·00, p=0·05).
• The obtained results demonstrate that the aEIR was lower in the intervention group than in the control group, but not significantly so (10·1 vs 15·2 infective bites per person, adjusted incidence rate ratio 0·80, 95% CI 0·36–1·80, p=0·59).