Efficacy of Atovaquone/Proguanil for Malaria Prophylaxis in Children and Its Effect on the Immunogenicity of Live Oral Typhoid and Cholera Vaccines

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 Gabone...

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Bibliographic Details
Published in:Clinical infectious diseases 2002-11, Vol.35 (10), p.1147-1154
Main Authors: Faucher, Jean-François, Binder, Ronnie, Missinou, Michel A., Matsiegui, Pierre-Blaise, Gruss, Holger, Neubauer, Rajko, Lell, Bertrand, Que, John U., Miller, Gerri B., Kremsner, Peter G.
Format: Article
Language:English
Subjects:
Administration, Oral
Adolescent
Antibodies
Antimalarials - pharmacology
Antimalarials - therapeutic use
Atovaquone
Bacterial diseases
Biological and medical sciences
Chemoprevention
Child
Child, Preschool
Children
Cholera
Cholera Vaccines - administration & dosage
Cholera Vaccines - immunology
Dosage
Double-Blind Method
Female
Human bacterial diseases
Human protozoal diseases
Humans
Immune response
Immunity - drug effects
Infectious diseases
Major Articles
Malaria
Malaria - prevention & control
Male
Medical sciences
Naphthoquinones - pharmacology
Naphthoquinones - therapeutic use
Parasitemia
Parasitic diseases
Placebos
Proguanil - pharmacology
Proguanil - therapeutic use
Protozoal diseases
Treatment Outcome
Tropical bacterial diseases
Tropical medicine
Typhoid fever
Typhoid-Paratyphoid Vaccines - administration & dosage
Typhoid-Paratyphoid Vaccines - immunology
Vaccination
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Summary: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.
ISSN:1058-4838
1537-6591
DOI:10.1086/342908