Please select the eligibility criteria that correspond to the clinical trial below.
Title: Evaluation of a Malaria Transmission Target Strategy Based on the Periodic Treatment With Sulfadoxine-Pyrimethamine vs. Early Case Management
Brief Summary: Recent, randomized controlled trials conducted in areas of perennial malaria transmission have shown that intermittent preventive treatment (IPT) given at the time of vaccination reduced the incidence of the first episode of malaria and severe anaemia during the first year of life by more than 50% without there being any rebound in the subsequent year. However, in countries such as Mali, where malaria is highly seasonal and prevalent in older children, IPT in infants may not be the optimum way in which to use antimalarial drugs to prevent malaria. An alternative approach is to give intermittent preventive treatment to children at risk just during the rainy season. Here we propose (i) to evaluate the impact of two seasonal IPT (sIPT) with Sulfadoxine-pyrimethamine (SP) given at 8 weeks interval on the incidence of malaria disease in children of 6 months to 10 years in an area of seasonal transmission, in Kambila, Mali; (ii) to assess the impact of this strategy on the in vivo response of P. falciparum to SP; (iii) to assess the potential rebound effect of this strategy on the subsequent transmission season after the cessation. Children 6 months-10 years in Kambila, Mali will randomized to receive either IPT with SP twice at 8 weeks interval or no IPT during the transmission season and will followed up for 12 months. Subjects will be also followed during the subsequent transmission season to assess possible rebound effect. Clinical malaria cases will be treated with SP and followed for 28 days to assess the in vivo response during both periods.


Options:
A: Inclusion Criteria:

* Age ≥ 8 to \< 14 years (boys), ≥ 8 to \< 12 years (girls)
* Student enrolled at participating school in classes 3-7
* Provision of informed consent from parent or guardian
* Provision of assent by student

Exclusion Criteria:

* Known allergy or history of adverse reaction to study medications
* Onset of menstruation (girls)
* Fever (≥ 37.5°C axillary) or history of fever in the previous 24 hours
* Evidence of severe malaria or danger signs
* Haemoglobin \< 7.0 gm/dL
* Parasite density \> 10,000/ul
B: Inclusion Criteria:

* Age 6 months to 10 years
* Agree to seek initial medical care for all medical illness in the study clinic during the study period
* Written informed consent by a parent or legal garden,
* No plan to travel for a long time during the study period.

Exclusion Criteria:

* History of allergy to sulfa drugs or Sulfadoxine-pyrimethamine
* Chronic illness or symptomatic malaria at the time of enrollment
C: Inclusion Criteria:

1. Age between 3 months and 5 years at enrolment.
2. Informed consent obtained from parents or legal guardians.
3. No current participation in another malaria intervention trial.

Exclusion Criteria:

1. Previous adverse reaction to treatment with SP or amodiaquine. If this is unknown, then a history of allergic reaction to any drug.
D: Inclusion Criteria:

* Enrolled in primary school, and attending regularly
* Enrolled in nursery or classes 1-7
* Informed consent from parent or guardian

Exclusion Criteria:

* Enrolled in primary class 8
* Haemoglobin level below 70g/L at baseline
* History of reaction to sulfa drugs (e.g. fansidar, septrin)
* History of severe skin reaction to any drug

Withdrawal criteria:

* Withdrawal of parental consent
* Haemoglobin level falling below 70g/L
* Severe adverse reaction to treatment

Answer: B