Intermittent preventive treatment involves the administration of a therapeutic dose of an antimalarial drug at predefined times regardless of an individual's infection status. The effect of administering intermittent preventive treatment in infants (IPTi) at the time of routine vaccination delivered through the Expanded Programme on Immunization (EPI) has been evaluated in several randomized controlled trials.4 10 A pooled analysis of the results of the first six trials of sulphadoxine pyrimethamine4 9 showed an overall protective efficacy of 30% (95% confidence interval, CI: 20 39) against clinical malaria, 38% (95% CI: 13 56) against hospital admission for infection with malaria parasites, 23% (95% CI: 10 34) against all cause hospital admission and 21% (95% CI: 8 33) against anaemia in the first year of life.11 One trial in an area of very high drug resistance to sulphadoxine pyrimethamine showed that such treatment had no effect, although the long acting drug mefloquine had a protective efficacy of 38% against clinical malaria.10 The strategy of administering IPTi using an efficacious, long acting antimalarial drug therefore has merit.
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