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Am. J. Trop. Med. Hyg., 70(1), 2004, pp. 1-7
Copyright © 2004 by The American Society of Tropical Medicine and Hygiene

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THE USE OF ANTI-MALARIAL DRUGS TO PREVENT MALARIA IN THE POPULATION OF MALARIA-ENDEMIC AREAS

BRIAN GREENWOOD
Department of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom

Anti-malarial drugs have been used in various ways to prevent malaria in the resident populations of endemic areas for nearly 100 years. The primary aim of most early studies was to interrupt transmission. This was rarely achieved, but administration of anti-malarial drugs either through medication of salt or by mass administration frequently led to a marked reduction in the prevalence of malaria infection and in the incidence of clinical attacks. Chemoprophylaxis is highly effective in reducing mortality and morbidity from malaria in young children and pregnant women living in endemic areas, but is difficult to sustain and, in some studies, has impaired the development of naturally acquired immunity. Intermittent preventive treatment, in which full therapeutic doses of a drug are given at defined intervals, has the potential to provide some of the benefits of sustained chemoprophylaxis in pregnant women and young children without some of its drawbacks and is a promising new approach to malaria control.

Acknowledgments: I thank David Schellenberg, Geoff Targett and Lorenz von Seidlein for their helpful comments on the manuscript. This paper is based on the Leon Jacobs Gorgas Memorial Lecture given at the National Institutes of Health, Bethesda, MD, on April 2, 2003.

Author’s address: Brian Greenwood, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, E-mail: brian.greenwood{at}lshtm.ac.uk.




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Copyright © 2004 by the American Society of Tropical Medicine and Hygiene.