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COCHRANE REVIEWS PRIZE WINNERS, 2008-2010/ CHEMOPROPHYLAXIS AND INTERMITTENT TREATMENT FOR PREVENTING MALARIA IN CHILDREN

Monday, 29th of July 2013

• COCHRANE REVIEWS PRIZE WINNERS, 2008-2012

Note to readers: The reviews which may be of particular interest to readers of this page are highlighted in red and reproduced on the homepage.

Excerpts from the write-up on the Warren Prize appear below; full text is at http://www.cochrane.org/about-us/awards-scholarships-funding-initiatives/annual-prizes-and-awards/kenneth-warren-prize along with weblinks to all prize winning reviews.

 

KENNETH WARREN

Kenneth Warren (1929-1996) was a larger-than-life man who was a source of encouragement and support for many young people, particularly those living in developing countries. He was very influential in drawing attention to the great neglected diseases that plague people in the poorer parts of the world. He was one of the first people to draw attention to the need for valid summaries of key research studies and to the way that electronic media could be used to disseminate the results of health research relevant to people in developing countries. Ken was an enthusiastic supporter of the pilot work in pregnancy and childbirth that led to the creation of The Cochrane Collaboration, and, with Fred Mosteller, he co-organised the meeting at the New York Academy of Sciences at which the vision for The Cochrane Collaboration was first made public [more information about Ken Warren].

The Kenneth Warren Prize
The Kenneth Warren Prize has been established with individual and institutional donations (see cochrane.org for details) to celebrate and recognise Kens interests. It was awarded for the first time at the 8th Cochrane Colloquium in Cape Town, South Africa, in 2000. The Prize is awarded annually to the principal author who is a national living in a developing country of a published Cochrane Review which is judged to be both of high methodological quality and relevant to health problems in developing countries.
The Prize for any given year is open to the principal author of a review published on the Cochrane Database of Systematic Reviews in The Cochrane Library, in Issues 4-12 of the previous year and issues 1-3 of the current year. In response to the call for nominations, authors may self-select their review(s) based on quality and relevance, and also Review Group editorial teams and other members of The Cochrane Collaboration may nominate specific reviews.

Kenneth Warren Prize recipients, 2008-2012.

2008 - Martin Meremikwu, University of Calabar, Nigeria. Chemoprophylaxis and intermittent treatment for preventing malaria in children [abstract].

2009 - Nandi Siegfried, South African Cochrane Centre, South African Medical Research Council, Tygerberg, South Africa. Male circumcision for prevention of heterosexual acquisition of HIV in men [abstract].

2010 - Prince Christopher, Cochrane Infectious Diseases Group and Christian Medical College, Vellore, India. Antibiotic therapy for Shigella dysentery [abstract].

2011 - Zohra Lassi, Cochrane Pregnancy and Childbirth Group and Aga Khan University Hospital, Karachi, Pakistan. Community based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes [abstract].

2012 - Don Mathanga, Cochrane Infectious Diseases Group and University of Malawi, Malaria Alert Center, College of Medicine, Blantyre, Malawi. Intermittent preventive treatment regimens for malaria in HIV-positive pregnant women [abstract].

·       CHEMOPROPHYLAXIS AND INTERMITTENT TREATMENT FOR PREVENTING MALARIA IN CHILDREN

1. Martin M Meremikwu^1,*, Sarah Donegan², Ekpereonne Esu³

Editorial Group: Cochrane Infectious Diseases Group

Published Online: 21 JAN 2009

Assessed as up-to-date: 14 NOV 2007

How to Cite

Meremikwu MM, Donegan S, Esu E. Chemoprophylaxis and intermittent treatment for preventing malaria in children. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD003756. DOI: 10.1002/14651858.CD003756.pub3.

Author Information

1. ¹ University of Calabar Teaching Hospital, Department of Paediatrics, Calabar, Cross River State, Nigeria
2. ² Liverpool School of Tropical Medicine, International Health Group, Liverpool, Merseyside, UK
3. ³ University of Calabar Teaching Hospital, Effective Health Care Research Programme - Nigeria, Calabar, Nigeria

^*Martin M Meremikwu, Department of Paediatrics, University of Calabar Teaching Hospital, PMB 1115, Calabar, Cross River State, Nigeria. mmeremiku@yahoo.co.uk.

Background

Malaria causes repeated illness in children living in endemic areas. Policies of giving antimalarial drugs at regular intervals (prophylaxis or intermittent treatment) are being considered for preschool children.

Objectives

To evaluate prophylaxis and intermittent treatment with antimalarial drugs to prevent malaria in young children living in malaria-endemic areas.

Search methods

We searched the Cochrane Infectious Diseases Group Specialized Register (August 2007), CENTRAL (The Cochrane Library 2007, Issue 3), MEDLINE (1966 to August 2007), EMBASE (1974 to August 2007), LILACS (1982 to August 2007), mRCT (February 2007), and reference lists of identified trials. We also contacted researchers.

Selection criteria

Individually randomized and cluster-randomized controlled trials comparing antimalarial drugs given at regular intervals (prophylaxis or intermittent treatment) with placebo or no drug in children aged one month to six years or less living in a malaria-endemic area.

Data collection and analysis

Two authors independently extracted data and assessed the risk of bias in the trials. We used risk ratio (RR) or mean difference with 95% confidence intervals (CI) for meta-analyses. Where we detected heterogeneity and considered it appropriate to combine the trials, we used the random-effects model (REM).

Main results

Twenty-one trials (19,394 participants), including six cluster-randomized trials, met the inclusion criteria. Prophylaxis or intermittent treatment with antimalarial drugs resulted in fewer clinical malaria episodes (RR 0.53, 95% CI 0.38 to 0.74, REM; 7037 participants, 10 trials), less severe anaemia (RR 0.70, 95% CI 0.52 to 0.94, REM; 5445 participants, 9 trials), and fewer hospital admissions for any cause (RR 0.64, 95% CI 0.49 to 0.82; 3722 participants, 5 trials). We did not detect a difference in the number of deaths from any cause (RR 0.90, 95% CI 0.65 to 1.23; 7369 participants, 10 trials), but the CI do not exclude a potentially important difference. One trial reported three serious adverse events with no statistically significant difference between study groups (1070 participants). Eight trials measured morbidity and mortality six months to two years after stopping regular antimalarial drugs; overall, there was no statistically significant difference, but participant numbers were small.

Authors conclusions

Prophylaxis and intermittent treatment with antimalarial drugs reduce clinical malaria and severe anaemia in preschool children.

 

Preschool children taking antimalarial drugs regularly are less likely to get malaria or severe anaemia, but more trials are needed to show whether survival is improved

Most children in areas where malaria is endemic are semi-immune against serious malaria by the age of seven, but for children under five the disease can be serious, and a million worldwide die each year from malaria. The review of 21 trials found that children taking regular antimalarial prophylaxis or intermittent treatment were less likely to get malaria, severe anaemia, or be admitted to hospital, but there was no change in the overall death rate. The benefits are similar in intermittent treatment of infants and prolonged prophylaxis, but long-term deleterious effects, including the possibility that it may interfere with the development of childrens immunity to malaria, are unknown for either regimen. Further trials with long-term follow up are needed.