Potential Impact of Intermittent Preventive Treatment (IPT) on Spread of Drug-Resistant Malaria
PLoS Medicine·
- DOI
- 10.1371/journal.pmed.0030141
- PMID
- 16573365
- PMCID
- PMC1440294
- OpenAlex
- W2099035607
- Study type
- Mathematical modelling
- Publisher
- Public Library of Science (PLoS)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings suggest that drug half-life and pre-existing resistance levels should inform the choice of antimalarial used for IPT, and that drugs with little existing resistance are not advisable for IPT in high-transmission areas.
Structured evidence summary
Research question
The study examines how intermittent preventive treatment (IPT) of asymptomatic individuals may influence the spread of drug-resistant malaria parasites.
Study design
A mathematical modelling study that translates individual treatment strategies and drug pharmacokinetics into parasite population dynamics to evaluate resistance spread.
Population and setting
The model addresses asymptomatic populations targeted by IPT, with results contextualised across low-transmission, high-transmission, and unstable transmission settings relevant to malaria-endemic regions.
Main findings
Immunity, treatment rate, drug decay kinetics, and presumptive treatment rate were identified as important factors in resistance spread. Partially resistant parasites were predicted to spread more readily in low-transmission settings, while fully resistant parasites were more likely to spread in high-transmission settings. IPTi could accelerate resistance spread, but the effect was predicted to be significant mainly in low or unstable transmission areas. IPT in adults was predicted to be less likely than IPTi to accelerate resistance spread in high-transmission settings.
Public-health relevance
The findings suggest that drug half-life and pre-existing resistance levels should inform the choice of antimalarial used for IPT, and that drugs with little existing resistance are not advisable for IPT in high-transmission areas.
Important limitations
The abstract notes the difficulty of addressing this question experimentally due to limited size and duration of IPTi trials and the difficulty of distinguishing resistance spread from conventional treatment versus IPTi when the same drug is used. As a mathematical modelling study, empirical confirmation is not provided within this article.
GIDS interpretation
This modelling paper provides a contextual framework for understanding how mass drug administration strategies could interact with resistance dynamics, which may be useful when considering future discoverability of related resistance or IPT literature. No direct connection to a live surveillance signal is established.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 8 auditable classifier relationships to diseases, places, topics, and study design.