Intermittent Preventive Treatment (IPT): Its Role in Averting Disease-Induced Mortality in Children and in Promoting the Spread of Antimalarial Drug Resistance
Open accessAbstract
We develop an age-structured ODE model to investigate the role of intermittent preventive treatment (IPT) in averting malaria-induced mortality in children, and its related cost in promoting the spread of antimalarial drug resistance. IPT, a malaria control strategy in which a full curative dose of an antimalarial medication is administered to vulnerable asymptomatic individuals at specified intervals, has been shown to reduce malaria transmission and deaths in children and pregnant women. However, it can also promote drug resistance spread. Our mathematical model is used to explore IPT effects on drug resistance and deaths averted in holoendemic malaria regions. The model includes drug-sensitive and drug-resistant strains as well as human hosts and mosquitoes. The basic reproduction, and invasion reproduction numbers for both strains are derived. Numerical simulations show the individual and combined effects of IPT and treatment of symptomatic infections on the prevalence of both strains and the number of lives saved. Our results suggest that while IPT can indeed save lives, particularly in high transmission regions, certain combinations of drugs used for IPT and to treat symptomatic infection may result in more deaths when resistant parasite strains are circulating. Moreover, the half-lives of the treatment and IPT drugs used play an important role in the extent to which IPT may influence spread of the resistant strain. A sensitivity analysis indicates the model outcomes are most sensitive to the reduction factor of transmission for the resistant strain, rate of immunity loss, and the natural clearance rate of sensitive infections.
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Some countries are exploring alternative drugs or combination therapies for IPT.
“However, some countries are now exploring alternative drugs or combination therapies for IPT [209–211].”
From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [211]
The Introduction (page unavailable) reports that a combination drug, sulfadoxine–pyrimethamine plus amodiaquine, has been used for IPT in infants and children. The Discussion and Conclusion (page unavailable) suggests considering additional IPT drugs, but does not say that countries are now exploring alternatives or combination therapies. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn areas of high seasonal malaria transmission, seasonal malaria chemoprevention with a combination of mefloquine, or amodiaquine and SP is being used as a strategy to reduce the incidence of malaria in pregnancy.
“To support this, in areas of high seasonal malaria transmission, seasonal malaria chemoprevention with a combination of mefloquine, or amodiaquine and SP is being used as a strategy to reduce the incidence of malaria in pregnancy [206, 211–213].”
From Current update on malaria in pregnancy: a systematic review (2025) · cites this paper as [211]
The Introduction says preventive treatment with SP reduces malaria incidence in pregnant women, but describes SP plus amodiaquine for infants and children, not pregnancy; it does not describe mefloquine for this purpose. The Discussion and Conclusion says the paper considers year-round transmission and leaves seasonal transmission for future work. Thus, the pregnancy-prevention point is supported, but the specified drugs and seasonal setting are not. (LLM, conf=0.90)
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Current update on malaria in pregnancy: a systematic review
Minwuyelet, A., Yewhalaw, D., Siferih, M., & Atenafu, G. (2025) · Tropical Diseases, Travel Medicine and Vaccines · doi:10.1186/s40794-025-00248-1 · Cited by 49 · see citing works
- Authors
- Manore, C. A., Teboh-Ewungkem, M. I., Prosper, O., Peace, A., Gurski, K., & Feng, Z.
- Affiliations
- Los Alamos National Laboratory (US)
- Lehigh University (US)
- University of Kentucky (US)
- Texas Tech University (US)
- Howard University (US)
- Purdue University West Lafayette (US)
- Corresponding author
- Manore, Carrie A.
- ORCID
- Venue
- Bulletin of Mathematical Biology
- Published
- 2018-10-31
- Volume
- 81
- Issue
- 1
- Pages
- 193-234
- ISSN
- 0092-8240 (ISSN-L)
- 1522-9602
- PMC
- PMC6320360
- OpenAlex
- W2581043098
- Cited by
- 18
- References
- 44
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 1 · 2020: 5
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Bulletin of Mathematical Biology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- OSTI OAI (U.S. Department of Energy Office of Scientific and Technical Information) (submittedVersion)
- ThinkTech (Texas Tech University) (submittedVersion, cc-by)
- Funders
- National Science Foundation (1361209)
- Directorate for Mathematical and Physical Sciences (1314029)
- American Institute of Mathematics (SquAREs)
- Simons Foundation (245237)
- Los Alamos National Laboratory (Director’s Postdoctoral Fellowship)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mathematical and Theoretical Epidemiology and Ecology Models
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- intermittent preventive treatment, malaria, antimalarial drug resistance, child mortality, holoendemic malaria, basic reproduction number, asymptomatic malaria, transmission reduction, loss of immunity, malaria control
- MeSH terms
- Mosquito Vectors, Antimalarials, Child, Computer Simulation, Drug Administration Schedule, Drug Combinations, Drug Resistance, Female, Humans, Male, Models, Biological, Plasmodium falciparum, Pregnancy, Pyrimethamine, Sulfadoxine, Pregnancy Complications, Parasitic, Malaria, Falciparum, Basic Reproduction Number, Mathematical Concepts
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