Reduction in malaria parasite rate in young children by distribution of prophylactic amodiaquine through voluntary village workers.

ABSTRACT

In Madang Province PNG voluntary dispensers in 36 villages distributed weekly amodiaquine to young children over 12 month period (July 1977 - June 1978). The tablets were distributed each week for over 70% of the study period. The slide positive rate for malarial parasites was markedly reduced from 29% to 3.7%.

ABSTRACT

PIP A pilot project was conducted in which 1300 young children received weekly amodiaquine from voluntary villages dispensers. The project involved 40 villages within a radius of 50 km of Madang town from June 1977-June 1978. The tablets were distributed each week for over 70% of the study period. In the treatment villages, the slide positive rate fell markedly and significantly after 12 months prophylaxis. All species showed the same significant response. The slide positive rates in the control villages failed to change significantly. In the treatment villages, the slide positive rate declined for all age groups but no change was recorded in the control villages. The reduction in parasite rate in the prophylaxis villages did not appear to be the result of the simultaneous spraying of DDT. In the prophylaxis villages, spraying had an effect, but it was not significant. In the sprayed villages, prophylaxis had a highly significant effect. In non-sprayed villages, prophylaxis had a highly significant effect. Of the children in the prophylaxis programs, 21% did not take the tablets on the Sunday prior to the 1978 blood collection and had a parasite rate of 5.4%. Of the children who took to prophylaxis on the preceding Sunday (79%), the parasite rate was 2.9%. For the July-December 1977 period, 929 children (62%) attended more than 80% of the time and 1197 children (79.9%) attended more than 60% of the time. The compliance did not deteriorate as the trial progressed; median compliance was slightly higher in the 2nd 6 months (78%) than in the 1st 6 months (75%). The Madang program has 2 phases the 1st phase protected children (0-5 years) from malaria by prophylaxis; the 2nd phase will be the provision of rapid access to treatment doses of antimalarials for older children. In sum, the study results show that young children in villages with voluntary village dispensers had a marked fall in parasite rates and in spleen rates.