trimethoprim--sulfamethoxazole-drug-combination and pirimiphos-methyl

There is limited evidence on whether malaria elimination is feasible in high-transmission areas of Africa. Between 2007 and 2018, we measured the impact of malaria control interventions in young children enrolled in three clinical trials and two observational studies in Tororo, Uganda, a historically high-transmission area. Data were pooled from children aged 0.5-2 years. Interventions included individually assigned chemoprevention and repeated rounds of indoor residual spraying (IRS) of insecticide. All children received long-lasting insecticidal nets (LLINs) and treatment for symptomatic malaria with artemisinin-based combination therapy. Malaria incidence was measured using passive surveillance and parasite prevalence by microscopy and molecular methods at regular intervals. Poisson's generalized linear mixed-effects models were used to estimate the impact of various control interventions. In total, 939 children were followed over 1,221.7 person years. In the absence of chemoprevention and IRS (reference group), malaria incidence was 4.94 episodes per person year and parasite prevalence 47.3%. Compared with the reference group, implementation of IRS was associated with a 97.6% decrease (95% CI: 93.3-99.1%,

Topics: Antimalarials; Artemisinins; Child, Preschool; Cohort Studies; Communicable Disease Control; Directly Observed Therapy; Female; Housing; Humans; Infant; Insecticides; Malaria, Falciparum; Male; Mosquito Control; Organothiophosphorus Compounds; Quinolines; Trimethoprim, Sulfamethoxazole Drug Combination; Uganda