Efficacy of atovaquone/proguanil for malaria prophylaxis in children and its effect on the immunogenicity of live oral typhoid and cholera vaccines

Clin Infect Dis. 2002 Nov 15;35(10):1147-54. doi: 10.1086/342908. Epub 2002 Oct 25.

Abstract

A double-blind, placebo-controlled study was conducted to measure the impact of malaria prophylaxis with atovaquone/proguanil (A-P) on the immunogenicity of vaccines against typhoid fever and cholera, Salmonella serotype Typhi Ty21a and Vibrio cholerae CVD103-HgR, respectively. A total of 330 Gabonese schoolchildren were assigned to receive either A-P or placebo for 12 weeks. Vaccination occurred 3 weeks after the start of prophylaxis, and immunogenicity was assessed 4 weeks after vaccination. The protective efficacy of A-P against Plasmodium falciparum malaria was of 97% (95% confidence interval, 79%-100%). The 2 treatment groups did not differ significantly with regard to changes in antibody titers after vaccination (P=.96 for anti-S. Typhi IgG antibodies, P=.07 for anti-S. Typhi IgA antibodies, and P=.64 for vibriocidal antibodies). The A-P combination was highly effective for malaria prophylaxis, without interfering with the in vivo immunogenicity of CVD103-HgR and Ty21a vaccines, and it could therefore be simultaneously administered with these vaccines.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adolescent
  • Antimalarials / pharmacology
  • Antimalarials / therapeutic use*
  • Atovaquone
  • Chemoprevention
  • Child
  • Child, Preschool
  • Cholera Vaccines / administration & dosage
  • Cholera Vaccines / immunology*
  • Double-Blind Method
  • Female
  • Humans
  • Immunity / drug effects*
  • Malaria / prevention & control*
  • Male
  • Naphthoquinones / pharmacology
  • Naphthoquinones / therapeutic use*
  • Proguanil / pharmacology
  • Proguanil / therapeutic use*
  • Treatment Outcome
  • Typhoid-Paratyphoid Vaccines / administration & dosage
  • Typhoid-Paratyphoid Vaccines / immunology*

Substances

  • Antimalarials
  • Cholera Vaccines
  • Naphthoquinones
  • Typhoid-Paratyphoid Vaccines
  • Proguanil
  • Atovaquone