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Intermittent Preventive Therapy
Intermittent preventive therapy or intermittent preventive treatment (IPT) is a public health intervention aimed at treating and preventing malaria episodes in infants (IPTi), children (IPTc), schoolchildren (IPTsc) and pregnant women (IPTp). The intervention builds on two tested malaria control strategies to clear existing parasites (treatment effect seen in mass drug administrations) and to prevent new infections (prophylaxis). IPTi IPTi using the antimalarial drug sulfadoxine/ pyrimethamine (S/P) was pioneered in Ifakara, Tanzania in 1999. Infants received S/P at ages 3, 6, and 9 months in combination with their routine childhood (EPI) vaccinations. IPTi reduced clinical attacks of malaria by 59% (95% CI, 41%–72%) in Ifakara. Remarkably, protection persisted throughout the second year of life, long after SP had disappeared from circulation. A trial conducted in northern Tanzania using the antimalarial drug amodiaquine instead of S/P was similarly successful. Six subsequent tria ...
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Public Health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the determinants of health of a population and the threats it faces is the basis for public health. The ''public'' can be as small as a handful of people or as large as a village or an entire city; in the case of a pandemic it may encompass several continents. The concept of ''health'' takes into account physical, psychological, and social well-being.What is the WHO definition of health?
from the Preamble to the Constitution of WHO as adopted by the International Health Conference, New York, 19 June - 22 July 1946; signed on ...
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Malaria
Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria. Malaria is caused by single-celled microorganisms of the ''Plasmodium'' group. It is spread exclusively through bites of infected ''Anopheles'' mosquitoes. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites travel to the liver where they mature and reproduce. Five species of ''Plasmodium'' can infect and be spread by h ...
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Mass Drug Administration
The administration of drugs to whole populations irrespective of disease status is referred to as mass drug administration (MDA). This article describes the administration of antimalarial drugs to whole populations an intervention which has been used as a malaria-control measure for more than 70 years. Recent proposals to eliminate or even to eradicate malaria have led to a renewed interest in mass drug administrations in areas with very high malaria endemicity. Drugs have been administered either directly as a full therapeutic course of treatment or indirectly through the fortification of salt. Mass drug administrations were generally unsuccessful in interrupting transmission but, in some cases, had a marked effect on parasite prevalence and on the incidence of clinical malaria. MDAs are likely to encourage the spread of drug-resistant parasites and so have only a limited role in malaria control. They may have a part to play in the management of epidemics and in the control of mal ...
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Prophylaxis
Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental health and efficiency. Leavell, H. R., & Clark, E. G. (1979). Preventive Medicine for the Doctor in his Community (3rd ed.). Huntington, NY: Robert E. Krieger Publishing Company. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention. Each year, millions of people die of preventable deaths. A 2004 study showed that about half of all deaths in the United States in 2000 were due to preventable behaviors and exposures. Leading causes included cardiovascular disease, ...
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Sulfadoxine
Sulfadoxine (also spelled sulphadoxine) is an ultra-long-lasting sulfonamide used in combination with pyrimethamine to treat malaria.Medical Treatment - Sulphadoxine and Pyrimethamine
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It is also used to prevent malaria but due to high levels of sulphadoxine-pyrimethamine resistance, this use has become less common. It is also used, usually in combination with other drugs, to treat or prevent various infections in livestock.


Mechanism of action

Sulfadoxine competitively inhibits , interfering with folate synthesis.


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Pyrimethamine
Pyrimethamine, sold under the brand name Daraprim among others, is a medication used with leucovorin (leucovorin is used to decrease side effects of pyrimethamine; it does not have intrinsic anti-parasitic activity) to treat the parasitic diseases toxoplasmosis and cystoisosporiasis. It is also used with dapsone as a second-line option to prevent ''Pneumocystis jiroveci'' pneumonia in people with HIV/AIDS. It was previously used for malaria but is no longer recommended due to resistance. Pyrimethamine is taken by mouth. Common side effects include gastrointestinal upset, severe allergic reactions, and bone marrow suppression. It should not be used by people with folate deficiency that has resulted in anemia. There is concern that it may increase the risk of cancer. While occasionally used in pregnancy it is unclear if pyrimethamine is safe for the baby. Pyrimethamine is classified as a folic acid antagonist. It works by inhibiting folic acid metabolism and therefore the ...
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Cluster Randomised Trial
A cluster-randomised controlled trial is a type of randomised controlled trial in which groups of subjects (as opposed to individual subjects) are randomised. Cluster randomised controlled trials are also known as cluster-randomised trials, group-randomised trials, and place-randomized trials. Cluster-randomised controlled trials are used when there is a strong reason for randomising treatment and control groups over randomising participants. Prevalence A 2004 bibliometric study documented an increasing number of publications in the medical literature on cluster-randomised controlled trials since the 1980s. Advantages Advantages of cluster-randomised controlled trials over individually randomised controlled trials include: * The ability to study interventions that cannot be directed toward selected individuals (e.g., a radio show about lifestyle changes) and the ability to control for "contamination" across individuals (e.g., one individual's changing behaviors may influence ano ...
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Amodiaquine
Amodiaquine (ADQ) is a medication used to treat malaria, including ''Plasmodium falciparum'' malaria when uncomplicated. It is recommended to be given with artesunate to reduce the risk of resistance. Due to the risk of rare but serious side effects, it is not generally recommended to prevent malaria. Though, the WHO in 2013 recommended use for seasonal preventive in children at high risk in combination with sulfadoxine and pyrimethamine. The side effects of amodiaquine are generally minor to moderate and are similar to those of chloroquine. Rarely liver problems or low blood cell levels may occur. When taken in excess headaches, trouble seeing, seizures, and cardiac arrest may occur. While not extensively studied as of 2007, it appeared to be safe in pregnancy. Amodiaquine is a 4-aminoquinoline compound related to chloroquine. Amodiaquine was first made in 1948. It is on the World Health Organization's List of Essential Medicines. While not available in the United States, it ...
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Bill & Melinda Gates Foundation
The Bill & Melinda Gates Foundation (BMGF), a merging of the William H. Gates Foundation and the Gates Learning Foundation, is an American private foundation founded by Bill Gates and Melinda French Gates. Based in Seattle, Washington, it was launched in 2000 and is reported as of 2020 to be the second largest charitable foundation in the world, holding $49.8 billion in assets. On his 43rd birthday, Bill Gates gave the foundation $1 billion. The primary stated goals of the foundation are to enhance healthcare and reduce extreme poverty across the world, and to expand educational opportunities and access to information technology in the U.S. Key individuals of the foundation include Bill Gates, Melinda French Gates, Warren Buffett, chief executive officer Mark Suzman, and Michael Larson. The BMGF had an endowment of approximately $50 billion . The scale of the foundation and the way it seeks to apply business techniques to giving makes it one of the leaders in venture phila ...
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Institute Of Medicine
The National Academy of Medicine (NAM), formerly called the Institute of Medicine (IoM) until 2015, is an American nonprofit, non-governmental organization. The National Academy of Medicine is a part of the National Academies of Sciences, Engineering, and Medicine, along with the National Academy of Sciences (NAS), National Academy of Engineering (NAE), and the National Research Council (NRC). The National Academy of Medicine provides national and international advice on issues relating to health, medicine, health policy, and biomedical science. It aims to provide unbiased, evidence-based, and authoritative information and advice concerning health and science policy to policy-makers, professionals, leaders in every sector of society, and the public at large. Operating outside the framework of the U.S. federal government, it relies on a volunteer workforce of scientists and other experts, operating under a formal peer-review system. As a national academy, the organization a ...
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DPT Vaccine
The DPT vaccine or DTP vaccine is a class of combination vaccines against three infectious diseases in humans: diphtheria, pertussis (whooping cough), and tetanus. The vaccine components include diphtheria and tetanus toxoids and either killed whole cells of the bacterium that causes pertussis or pertussis antigens. The term toxoid refers to vaccines which use an inactivated toxin produced by the pathogen which they are targeted against in order to generate an immune response. In this way, the toxoid vaccine generates an immune response which is targeted against the toxin which is produced by the pathogen and causes disease, rather than a vaccine which is targeted against the pathogen itself. The whole cells or antigens will be depicted as either "DTwP" or "DTaP", where the lower-case "w" indicates whole-cell inactivated pertussis and the lower-case "a" stands for “acellular”. In comparison to alternative vaccine types, such as live attenuated vaccines, the DTP vaccine do ...
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