Implementation of the intermittent preventive treatment of malaria in school-aged children (IPTsc) in moderate and high endemic areas in Tanzania: a policy brief.

Makenga, Geofrey; Baraka, Vito; Minja, Daniel T R; Chiduo, Mercy; Mmbando, Bruno P; Seth, Misago D; Lusasi, Abdallah; Chacky, Frank et al. · EClinicalMedicine · 2025

expert_opinion · Level V

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Abstract

In high-transmission settings, up to 70% of school-aged children (SAC; 5-15 years) harbour malaria parasites, mostly asymptomatically. This contributes significantly to school absenteeism (13-50%) and anaemia (61%), impairing cognitive development and academic performance. Despite this burden, SAC are often excluded from malaria-targeted interventions and act as a key reservoir for transmission. Intermittent Preventive Treatment for school-aged children (IPTsc), recommended by the World Health Organization (WHO), involves administering a full antimalarial treatment course at regular intervals to prevent infection. This policy brief follows a successful clinical trial and large-scale implementation research in Tanzania that demonstrated IPTsc's operational feasibility and effectiveness. Administering Dihydroartemisinin-Piperaquine (DP) through school-based delivery proved safe, cost-effective, acceptable to communities, and led to significant reductions in malaria prevalence. These findings support IPTsc as a complementary malaria control strategy in endemic areas with moderate to high transmission. Countries with similar epidemiological profiles are encouraged to adopt IPTsc as part of their national malaria control strategies. The Global Fund, via the Ministry of Health, Tanzania (implementation research pilot of IPTsc), and Flemish Interuniversity Council (VLIR-UOS), Belgium, TEAM initiative, grant TZ2017TEA451A102 (clinical trial).