{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:51:13Z","timestamp":1774612273417,"version":"3.50.1"},"reference-count":39,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,12]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Intermittent preventive treatment of malaria among schoolchildren (IPTsc) reduces clinical malaria, asymptomatic parasitemia, and anemia. The effects of IPTsc by gender have not been studied longitudinally. We investigated overall IPTsc efficacy and conducted a secondary analysis to explore gender-specific differences. We enrolled schoolchildren aged 6\u201313 years in an open-label, rolling-cohort randomized controlled trial between September 2007 and February 2013 in Kolle, Mali. Annually, schoolchildren received two full-treatment courses of sulfadoxine-pyrimethamine (SP) plus artesunate, or amodiaquine (AQ) plus artesunate, or no malaria treatment as control. We used mixed-effects generalized linear models to estimate differences in treatment outcomes across groups with interaction terms to explore gender-specific differences associated with <jats:italic>Plasmodium falciparum<\/jats:italic> infection, hemoglobin, and grade point averages (GPA) based on standardized testing. Overall, 305 students contributed 4,564 observations. Compared with the control, SP plus artesunate and AQ plus artesunate reduced the odds of <jats:italic>P. falciparum<\/jats:italic> infection (odds ratio [OR]: 0.33, 95% CI: 0.26\u20130.43; OR: 0.46, 95% CI: 0.36\u20130.59). We found strong evidence of increased mean hemoglobin concentrations (g\/dL) in the SP plus artesunate group versus control (difference +0.37, 95% CI: 0.13\u20130.58). Collectively, schoolchildren given AQ plus artesunate had higher mean GPA (difference +0.36, 95% CI: 0.02\u20130.69) relative to control. Schoolgirls, compared with schoolboys, given SP plus artesunate had greater improvement in GPA (+0.50, 95% CI: \u22120.02 to 1.02 versus \u22120.27, 95% CI: \u22120.71 to 0.16); interaction <jats:italic>P<\/jats:italic> = 0.048, respectively. The IPTsc decreases <jats:italic>P. falciparum<\/jats:italic> infections in schoolchildren. Treatment regimens that include longer-acting drugs may be more effective at decreasing malaria-related anemia and improving educational outcomes as observed among girls in this setting.<\/jats:p>","DOI":"10.4269\/ajtmh.21-1218","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T13:04:57Z","timestamp":1661173497000},"page":"796-803","source":"Crossref","is-referenced-by-count":3,"title":["Overall and Gender-Specific Effects of Intermittent Preventive Treatment of Malaria with Artemisinin-Based Combination Therapies among Schoolchildren in Mali: A Three-Group Open Label Randomized Controlled Trial"],"prefix":"10.4269","volume":"107","author":[{"given":"Hamma","family":"Maiga","sequence":"first","affiliation":[{"name":"Institut National de Sant\u00e9 Publique, Bamako, Mali;"},{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Opondo","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Matthew","family":"Chico","sequence":"additional","affiliation":[{"name":"Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren M.","family":"Cohee","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Issaka","family":"Sagara","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oumar B.","family":"Traore","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mamadou","family":"Tekete","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Dara","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoumana I.","family":"Traore","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Modibo","family":"Diarra","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samba","family":"Coumare","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aly","family":"Kodio","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amadou","family":"Bamadio","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bouran","family":"Sidibe","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ogobara K.","family":"Doumbo","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdoulaye A.","family":"Djimde","sequence":"additional","affiliation":[{"name":"Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"World Malaria Report 2021. 21 Years of Global Progress & 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Malawi","volume":"17","year":"2018"},{"key":"b7","series-title":"Trop Med Int Health","first-page":"1294","article-title":"Malaria in school-age children in Africa: an increasingly important challenge","volume":"19","year":"2014"},{"key":"b8","year":"2002"},{"key":"b9","series-title":"Soc Sci Med","first-page":"324","article-title":"Malaria and primary education in Mali: a longitudinal study in the village of Don\u00e9gu\u00e9bougou","volume":"71","year":"2010"},{"key":"b10","series-title":"BMC Health Serv Res","first-page":"165","article-title":"From strategy development to routine implementation: the cost of intermittent preventive treatment in infants for malaria control","volume":"8","year":"2008"},{"key":"b11","series-title":"Technical Expert Group Meeting on Intermittent Preventive Treatment in Pregnancy (IPTp)","year":"2007"},{"key":"b12","series-title":"Policy Recommendation on Intermittent Preventive Treatment during Infancy with Sulphadoxine-Pyrimethamine (SP-IPTi) for Plasmodium falciparum Malaria Control in Africa","year":"2010"},{"key":"b13","year":"2012"},{"key":"b14","series-title":"Lancet Glob Health","first-page":"e1499","article-title":"Preventive malaria treatment among school-aged children in sub-Saharan Africa: a systematic review and meta-analyses","volume":"8","year":"2020"},{"key":"b15","series-title":"Malar J","first-page":"157","article-title":"Plasmodium falciparum parasitaemia and clinical malaria among school children living in a high transmission setting in western Kenya","volume":"15","year":"2016"},{"key":"b16","series-title":"Am J Trop Med Hyg","first-page":"779","article-title":"The high burden of malaria in primary school children in southern Malawi","volume":"93","year":"2015"},{"key":"b17","series-title":"Trop Med Int Health","first-page":"784","article-title":"Intermittent preventive treatment using artemisinin-based combination therapy reduces malaria morbidity among school-aged children in Mali","volume":"14","year":"2009"},{"key":"b18","series-title":"Trop Med Infect Dis","first-page":"5: 148","article-title":"Impact of three-year intermittent preventive treatment using artemisinin-based combination therapies on malaria morbidity in Malian schoolchildren","year":"2020"},{"key":"b19","series-title":"Am J Trop Med Hyg","first-page":"790","article-title":"Spatial patterns of Plasmodium falciparum clinical incidence, asymptomatic parasite carriage and Anopheles density in two villages in Mali","volume":"93","year":"2015"},{"key":"b20","series-title":"Am J Trop Med Hyg","first-page":"467","article-title":"Community pyrimethamine-sulfadoxine use and prevalence of resistant Plasmodium falciparum genotypes in Mali: a model for deterring resistance","volume":"55","year":"1996"},{"key":"b21","series-title":"Malar J","first-page":"82","article-title":"Spatio-temporal analysis of malaria within a transmission season in Bandiagara, Mali","volume":"12","year":"2013"},{"key":"b22","year":"2011"},{"key":"b23","series-title":"Lancet","first-page":"127","article-title":"Effect of intermittent preventive treatment of malaria on health and education in schoolchildren: a cluster-randomised, double-blind, placebo-controlled trial","volume":"372","year":"2008"},{"key":"b24","series-title":"Clin Infect Dis","first-page":"1404","article-title":"Impact of intermittent preventive treatment with dihydroartemisinin-piperaquine on malaria in Ugandan schoolchildren: a randomized, placebo-controlled trial","volume":"58","year":"2014"},{"key":"b25","series-title":"Malar J","first-page":"450","article-title":"Efficacy and safety of intermittent preventive treatment for malaria in schoolchildren: a systematic review","volume":"14","year":"2015"},{"key":"b26","series-title":"Report on the Malaria Conference in Equatorial Africa. Held under the joint auspices of the World Health Organization and of the commission for technical co-operation in Africa south of the Sahara","first-page":"72","year":"1951"},{"key":"b27","series-title":"Clin Pharmacokinet","first-page":"263","article-title":"Pharmacokinetics of quinine, chloroquine and amodiaquine. Clinical implications","volume":"30","year":"1996"},{"key":"b28","series-title":"PLoS One","first-page":"e0162718","article-title":"Seasonal malaria chemoprevention with sulphadoxine-pyrimethamine and amodiaquine selects Pfdhfr-dhps quintuple mutant genotype in Mali","volume":"11","year":"2016"},{"key":"b29","series-title":"Am J Trop Med Hyg","first-page":"1102","article-title":"Asymptomatic Plasmodium infection and cognition among primary schoolchildren in a high malaria transmission setting in Uganda","volume":"88","year":"2013"},{"key":"b30","series-title":"Nutrients","first-page":"8: 693","article-title":"The proportion of anemia associated with iron deficiency in low, medium, and high human development index countries: a systematic analysis of national surveys","year":"2016"},{"key":"b31","series-title":"PLoS One","first-page":"e12589","article-title":"Pathophysiological mechanisms of severe anaemia in Malawian children","volume":"5","year":"2010"},{"key":"b32","series-title":"Am J Trop Med Hyg","first-page":"25","article-title":"Reducing the burden of anemia in infants and young children in malaria-endemic countries of Africa: from evidence to action","volume":"71","year":"2004"},{"key":"b33","series-title":"Malar J","first-page":"7","article-title":"Disparities of Plasmodium falciparum infection, malaria-related morbidity and access to malaria prevention and treatment among school-aged children: a national cross-sectional survey in Cote d\u2019Ivoire","volume":"14","year":"2015"},{"key":"b34","series-title":"Am J Trop Med Hyg","first-page":"450","article-title":"Predictors of Plasmodium falciparum malaria incidence in Chano Mille, South Ethiopia: a longitudinal study","volume":"87","year":"2012"},{"key":"b35","series-title":"Malar J","first-page":"260","article-title":"Prevalence of Malaria parasitaemia in school children from two districts of Ghana earmarked for indoor residual spraying: a cross-sectional study","volume":"14","year":"2015"},{"key":"b36","series-title":"Infect Immun","first-page":"3190","article-title":"Involvement of gonadal steroids and gamma interferon in sex differences in response to blood-stage malaria infection","volume":"74","year":"2006"},{"key":"b37","series-title":"PLoS Med","first-page":"e1001594","article-title":"Impact of intermittent screening and treatment for malaria among school children in Kenya: a cluster randomised trial","volume":"11","year":"2014"},{"key":"b38","series-title":"Ann Nutr Metab","first-page":"85","article-title":"Immune-enhancing role of vitamin C and zinc and effect on clinical conditions","volume":"50","year":"2006"},{"key":"b39","series-title":"Br J Clin Pharmacol","first-page":"485","article-title":"Pharmacokinetics and electrocardiographic pharmacodynamics of artemether-lumefantrine (Riamet) with concomitant administration of ketoconazole in healthy subjects","volume":"54","year":"2002"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/107\/4\/article-p796.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/107\/4\/article-p796.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/107\/4\/article-p796.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T16:05:53Z","timestamp":1665590753000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/107\/4\/article-p796.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,12]]},"references-count":39,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.21-1218","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,12]]}}}