***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background Recent studies have shown that intermittent preventive malaria treatment ( IPT ) in infants in areas of stable malaria transmission reduces malaria and severe anaemia incidence . However in most areas malaria morbidity and mortality remain high in older children . Methods To evaluate the effect of seasonal IPT with sulphadoxine pyrimethamine ( SP ) on incidence of malaria disease in area of seasonal transmission , 262 children 6 months-10 years in Kambila , Mali were r and omized to receive either IPT with SP twice at eight weeks interval or no IPT during the transmission season of 2002 and were followed up for 12 months . Subjects were also followed during the subsequent transmission season in 2003 to assess possible rebound effect . Clinical malaria cases were treated with SP and followed to assess the in vivo response during both periods . Results The incidence rate of malaria disease per 1,000 person-months during the first 12 months was 3.2 episodes in the treatment group vs. 5.8 episodes in the control group with age-adjusted Protective Efficacy ( PE ) of 42.5 % ; [ 95 % CI 28.6%–53.8 % ] . When the first 16 weeks of follow up is considered age-adjusted PE was 67.5 % [ 95 % CI 55.3 % – 76.6 % ] . During the subsequent transmission season , the incidence of clinical malaria per 1000 persons-days was similar between the two groups ( 23.0 vs 21.5 episodes , age-adjusted IRR = 1.07 [ 95 % CI , 0.90–1.27 ] ) . No significant difference was detected in in vivo response between the groups during both periods . Conclusion Two malaria intermittent treatments targeting the peak transmission season reduced the annual incidence rate of clinical malaria by 42.5 % in an area with intense seasonal transmission . This simple strategy is likely to be one of the most effectives in reducing malaria burden in such areas .Trial Registration Clinical trials.gov OBJECTIVE To assess the efficacy of intermittent preventive treatment ( IPT ) against malaria in school-aged children . METHODS This was an open r and omized controlled trial of seasonal IPT among school children ( IPTsc ) aged 6 - 13 years in Kollé , Mali . The study began in September 2007 and completed follow-up in May 2008 . Students were r and omized to one of three study arms : Sulfadoxine-pyrimethamine plus artesunate ( SP/AS ) , amodiaquine plus artesunate ( AQ/AS ) or vitamin C. All students received two full treatment doses , given 2 months apart during the season of high transmission from September to December . Groups were compared with respect to incidence of clinical malaria , asymptomatic parasitemia and haemoglobin concentration . RESULTS A total of 296 students were r and omized , and retention in the study was 99.3 % . Clinical malaria incidence in the SP/AS and AQ/AS arms was reduced by 66.6 % and 46.5 % , respectively , vs. vitamin C ( P < 0.001 ) . There were fewer clinic visits for any cause among the children receiving SP/AS or AQ/AS ( P = 0.024 ) . The prevalence of asymptomatic parasitemia was fivefold higher in the vitamin C arm than either SP/AS or AQ/AS at each post-treatment evaluation ( P < 0.001 ) . At the end of the transmission period , children treated with IPT had lower rates of anaemia ( SP/AS , 17.7 % ; AQ/AS , 16.0 % ; vitamin C , 29.6 % ; P = 0.039 ) . CONCLUSION  IPT among school children reduced the rates of clinical malaria , all-cause acute clinic visits , asymptomatic parasitemia and anaemia among school-aged children A r and omized trial reported by Diadier Diallo and colleagues shows that intermittent preventive treatment for malaria in children who are protected from mosquitoes using insecticide-treated bednets provides substantial protection from malaria Background Malaria and anaemia are the leading causes of morbidity and mortality in children in sub-Saharan Africa . We have investigated the effect of intermittent preventive treatment with sulphadoxine-pyrimethamine or artesunate plus amodiaquine on anaemia and malaria in children in an area of intense , prolonged , seasonal malaria transmission in Ghana . Methods 2451 children aged 3–59 months from 30 villages were individually r and omised to receive placebo or artesunate plus amodiaquine ( AS+AQ ) monthly or bimonthly , or sulphadoxine-pyrimethamine ( SP ) bimonthly over a period of six months . The primary outcome measures were episodes of anaemia ( Hb<8.0 g/dl ) or malaria detected through passive surveillance . Findings Monthly artesunate plus amodiaquine reduced the incidence of malaria by 69 % ( 95 % CI : 63 % , 74 % ) and anaemia by 45 % ( 95 % CI : 25%,60 % ) , bimonthly sulphadoxine-pyrimethamine reduced the incidence of malaria by 24 % ( 95 % CI : 14%,33 % ) and anaemia by 30 % ( 95 % CI : 6 % , 49 % ) and bimonthly artesunate plus amodiaquine reduced the incidence of malaria by 17 % ( 95 % CI : 6 % , 27 % ) and anaemia by 32 % ( 95 % CI : 7 % , 50 % ) compared to placebo . There were no statistically significant reductions in the episodes of all cause or malaria specific hospital admissions in any of the intervention groups compared to the placebo group . There was no significant increase in the incidence of clinical malaria in the post intervention period in children who were > 1 year old when they received IPTc compared to the placebo group . However the incidence of malaria in the post intervention period was higher in children who were < 1 year old when they received AS+AQ monthly compared to the placebo group . Interpretation IPTc is safe and efficacious in reducing the burden of malaria in an area of Ghana with a prolonged , intense malaria transmission season . Trial Registration Clinical Trials.gov BACKGROUND In areas of endemic transmission , malaria in pregnancy is associated with severe maternal anaemia and low-birthweight babies . We studied the efficacy of intermittent treatment doses of sulphadoxine-pyrimethamine in preventing malaria and severe anaemia in pregnancy in a double-blind placebo-controlled trial among primigravid women living in Kilifi District , Kenya . METHODS Between January , 1996 , and April , 1997 , 1264 primigravid women were recruited when they attended for antenatal care , and r and omly assigned sulphadoxine-pyrimethamine ( 640 ) or placebo ( 624 ) . Women received one , two , or three doses of study medication depending on the duration of gestation at enrolment . Primary outcome measures were severe anaemia ( haemoglobin < 8 g/dL ) and malaria parasitaemia , assessed at 34 weeks of gestation . Analyses were based on intention to treat among women who had study blood tests at 34 weeks . FINDINGS 30 ( 5.3 % ) of 567 women in the sulphadoxine-pyrimethamine group and 199 ( 35.3 % ) of 564 in the placebo group had peripheral parasitaemia ( protective efficacy 85 % [ 95 % CI 78 - 90 ] , p<0.0001 ) . 82 ( 14.5 % ) and 134 ( 23.7 % ) had severe anaemia ( protective efficacy 39 % [ 22 - 52 ] , p<0.0001 ) . Even women who booked late and received only one dose of sulphadoxine-pyrimethamine benefited significantly from the intervention . The effects were seen both in women who owned insecticide-treated bednets and in women who did not . INTERPRETATION Intermittent presumptive treatment with sulphadoxine-pyrimethamine is an effective , practicable strategy to decrease the risk of severe anaemia in primigravidae living in malarious areas Background Education is a key element in the socioeconomic development required to improve quality of life in Kenya . Despite the introduction of free primary education , primary school enrollment and attendance levels remain low . Drawing on qualitative and quantitative data , this study explores the determinants of non-enrollment and absenteeism in rural western Kenya and potential mitigation strategies to address these issues . Methods The study was conducted in Bwaliro village in rural western Kenya . A r and om sample of 64 students was obtained by blocking the village primary school ’s student population according to grade level , gender , and orphan status . Qualitative and quantitative data were collected through interviews with parents , guardians , and key informants , and focus group discussion s with students . Quantitative data were compared using chi-square tests , Student ’s T-test , and Poisson regressions . Qualitative data were analyzed using thematic content analysis . Results Malaria , menstruation , and lack of money were among the most notable determinants of primary school dropout and absenteeism , and these factors disproportionately impacted orphans and female students . Potential mitigation strategies suggested by the community included provision of malaria treatment or prevention , reduction in education costs , expansion of the established school-feeding program , and provision of sanitary pads . Conclusion Despite free primary education , numerous factors continue to prevent children in rural western Kenya from attending primary school . The findings suggest that interventions should primarily target orphaned and female students . Prior to implementation , suggested mitigation strategies should be assessed for cost-effectiveness Summary Background Malaria is a major cause of morbidity and mortality in early childhood , yet its consequences for health and education during the school-age years remain poorly understood . We examined the effect of intermittent preventive treatment ( IPT ) in reducing anaemia and improving classroom attention and educational achievement in semi-immune schoolchildren in an area of high perennial transmission . Methods A stratified , cluster-r and omised , double-blind , placebo-controlled trial of IPT was done in 30 primary schools in western Kenya . Schools were r and omly assigned to treatment ( sulfadoxine-pyrimethamine in combination with amodiaquine or dual placebo ) by use of a computer-generated list . Children aged 5–18 years received three treatments at 4-month intervals ( IPT n=3535 , placebo n=3223 ) . The primary endpoint was the prevalence of anaemia , defined as a haemoglobin concentration below 110 g/L. This outcome was assessed through cross-sectional surveys 12 months post-intervention . Analysis was by both intention to treat , excluding children with missing data , and per protocol . This study is registered with Clinical Trials.gov , number NCT00142246 . Findings 2604 children in the IPT group and 2302 in the placebo group were included in the intention-to-treat analysis of the primary outcome ; the main reason for exclusion was loss to follow-up . Prevalence of anaemia at 12 months averaged 6·3 % in the IPT group and 12·6 % in the placebo group ( adjusted risk ratio 0·52 , 95 % CI 0·29–0·93 ; p=0·028 ) . Significant improvements were also seen in two of the class-based tests of sustained attention , with a mean increase in code transmission test score of 6·05 ( 95 % CI 2·83–9·27 ; p=0·0007 ) and counting sounds test score of 1·80 ( 0·19–3·41 ; p=0·03 ) , compared with controls . No effect was shown for inattentive or hyperactive-compulsive behaviours or on educational achievement . The per- protocol analysis yielded similar results . 23 serious adverse events were reported within 28 days of any treatment ( 19 in the IPT group and four in the placebo group ) ; the main side-effects were problems of balance , dizziness , feeling faint , nausea , and /or vomiting shortly after treatment . Interpretation IPT of malaria improves the health and cognitive ability of semi-immune schoolchildren . Effective malaria interventions could be a valuable addition to school health programmes . Funding Gates Malaria Partnership , the Norwegian Education Trust Fund and multidonor Education Development Programme Fund of the World Bank , DBL Centre for Health Research and Development , and the Wellcome Trust The factors contributing to anemia in falciparum malaria were characterized in 4,007 prospect ively studied patients on the western border of Thail and . Of these , 727 patients ( 18 % ) presented with anemia ( haematocrit < 30 % ) , and 1 % ( 55 of 5,253 ) required blood transfusion .  The following were found to be independent risk factors for anemia at admission : age < 5 years , a palpable spleen , a palpable liver , recrudescent infections , being female , a prolonged history of illness ( > 2 days ) before admission , and pure Plasmodium falciparum infections rather than mixed P. falciparum and Plasmodium vivax infections . The mean maximum fractional fall in hematocrit after antimalarial treatment was 14.1 % of the baseline value ( 95 % confidence interval [ CI ] , 13.6 - 14.6 ) . This reduction was significantly greater in young children ( aged < 5 years ) and in patients with a 
    Output:
    
No severe adverse events were associated with the drugs used for IPTsc .
Conclusion IPTsc may reduce the malaria-related burden in schoolchildren .