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Impact of Intermittent Preventive Anti-Malarial Treatment on the Growth and

Nutritional Status of Preschool Children in Rural Senegal (West Africa)

Introduction
Researchers were finding that many children in West Africa (Senegal) ages
under 5 were dying from the effects and aftereffects of malaria, especially
malnutrition. This had been going on for many years, and demographics since
1983 had shown that malaria and malnutrition were responsible for about 25% of
child deaths.
Now, the reason for the researchers choosing this subject is vague,
although reasonably obvious. It would appear that the researchers were trying to
lower the mortality rate in West Africa for ethical reasons, because the huge death
rate in the children was horrific.
The researchers were trying to gather information of the childrens
physical health during the seasonal intermittent preventive treatment, and they
specifically measured their weight, triceps skinfold, subscapular skinfold, and
height to see just how well the treatment worked. Their study was important
because if malaria prevention could be implemented in West Africa, then less
people would die there.
As for test subjects, the researchers were testing their intermittent
preventative treatment (IPT) on children to see if it could successfully prevent
malaria. The idea was that if the childrens anthropometric data ended up being at
a healthy range by the end of the study, then the treatment would be successful.

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Materials and Methods
The scientists did their experiments by taking all sorts of measurements of
the children they used. The children they tested were analyzed before, after, and
during their treatment, which took the course of two years. For the before data
collected, data collected was mainly demographic, including anything from age to
the religion of the children used. Now, the analyzing during the experiment had
many measurements of various body parts to determine how healthy the child was
during the treatment; the analyzing for after, which took place in July and
December of year two, was another physical test, which essentially told the
researchers if the treatment had been successful or not.
As for specifics on the body measurements, the researchers had two
trained people measure the children. The trained people calculated weight/mass
using baby scales and electronic scales from Germany and France (respectively)
that measured precisely down to the nearest 10g or 100g (respectively) depending
on the age of the child. For height measurements, measurements to the nearest
millimeter were taken. For triceps and subscapular skinfold thickness, a Holtain
adipometer was used to measure to the nearest 0.2 mm. Of course, its important
to note that each measurement--except for height--was taken twice and then
averaged. As for the demographics, the researchers themselves went out to rural
Senegal and asked for participants, with parent consent. Censuses were also used
to help find participants.
Results

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The results from the use of IPT were that stunting decreased in year 2
from 21% to 12.2%. The problem of being underweight was reduced from 26.2%
to 14.3% by year two, and researches observed: [This reduced weight] remained
constant thereafter (Ntab et al). These results showed a positive impact of the
IPT. There were also results that showed there was a huge difference in weight
gain between the intervention group and the control group, with no percentages
given, but an estimated 3xs greater weight gain of the intervention group than the
control group.
The only unexpected outcome was that stunting decreased by about 50%
during a rainy season in year 2, when no preventative treatment was being given.
Discussion
If the researchers had had a hypothesis, it would have been that IPT would
decrease deaths because of the health benefits IPT would provide. The results
proved this, because stunting decreased and weight and arm circumference
increased. However, it was also a little disproved because it did not show any
significant height difference as compared to other studies. Overall though, they
were able to conclude that IPT, at the very least, helped physical conditions if
malaria hit.
On the other hand, IPT did have some limitations, and researchers found
that they werent able to study truly suffering malaria patients, as the children
they experimented on got pampered with home visits. They also observed
nutritional status during the time they gave the third dose, which suggests that
they didnt get accurate results for the third dose since it would take time to see

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actual results. The treatment was preventive, not to necessarily cure during the
outbreak of malaria.

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Bibliography
Ntab, Balthazar; Cisse, Badara; Boulanger, Denis; Sokhna, Cheikh; Targett, Georffrey;
Lines, Jo; Alexander, Neal; Trape, Jean-Francois; Greenwood, Brian M.; and
Simondon, Kirsten B. "Impact of Intermittent Preventive Anti-Malarial Treatment
on the Growth and Nutritional Status of Preschool Children in Rural Senegal
(West Africa)." The American Journal of Tropical Medicine and Hygiene
(2001): 411-417. PDF .