HIV/AIDS remains one of the world’s most significant public health challenges, particularly in developing countries. The Human Immunodeficiency Virus (HIV-1), the variant responsible for the pandemic, has the ability to infect different cell types such as T cells, macrophages and dendritic cells (DC). These latter cells are crucial in the defense against infectious agents and play a major role in viral pathogenesis. The present study, published in PLoS ONE and led by researchers from Hospital Clinic de Barcelona-IDIBAPS, within the framework of HIVACAT, shows for the first time that dendritic cells in HIV-infected patients who spontaneously control the infection produce high levels of α-defensins 1 -3. This is associated with slower disease progression, suggesting potential diagnostic, therapeutic and preventive implications. The first author of this study is Dr. Marta Rodriguez-Garcia, Emili Letang Fellowship award from Hospital Clinic of Barcelona for her work in this line of research, and currently a postdoc at The Ragon Institute of Massachusetts General Hospital, Massachusetts Institute of Technology and Harvard. The senior researchers of the study are Dr. Teresa Gallart, from the Immunology Service of Hospital Clinic and collaborator of the IDIBAPS team on Infectious Diseases and AIDS, and Dr. Josep M ª Gatell, Head of the Infectious Diseases Department at the Hospital Clinic, professor at the Department of Medicine of the University of Barcelona and leader of the same IDIBAPS team.

The study was done in collaboration with the Catalan Center for HIV Vaccine Research and Development (HIVACAT), a public-private partnership involving IrsiCaixa Foundation and the Infectious Diseases Department at the Hospital Clinic of Barcelona. The research conducted within this initiative is made in coordination with Esteve and with the support of “La Caixa” Foundation and the Health and the Innovation, Universities and Enterprise Departments of the Generalitat de Catalunya.

Defensins are endogenous antimicrobial peptides with broad-spectrum antimicrobial properties and immunomodulatory effects. They have a potent anti-HIV activity, acting directly on the virus and also in target cells. According to its structure, human defensins are classified into two subfamilies: α-defensins and β-defensins, both with anti-HIV activity. The α-defensins, also known as human neutrophil peptides, are stored in neutrophils and, to a lesser extent, in other types of leukocytes. Although the anti-HIV activity of α-defensins1-3 has been clearly demonstrated in vitro, their possible protective role during HIV infection in vivo remains uncertain.

The authors recently demonstrated that α-defensins1-3 are produced by monocyte-derived immature dendritic cells (MDDC) in healthy individuals and they are able to modulate the maduration and differentiation process of MDDC. Dendritic cells (DC) are the main antigen-presenting cells and play a key role in the innate immune response against different viral infections, especially during the response generated against HIV. Due to their mucosal localization, DC are thought to be one of the first cells that encounter the HIV and, after migration to the lymph nodes, they would mediate the transmission of HIV-1 virions to CD4 T cells, the main source of HIV-1 replication and dissemination. For this study, a valid model of in vivo myeloid DC, the MDDC, was analysed. These might be one of the key cells involved in early HIV infection, and therefore their capacity to produce and release α-defensins1-3 by DC may have physiological relevance.

The study enrolled healthy, non-infected controls and HIV-1-infected subjects. These HIV-1-infected individuals were classified as: elite controllers (patients able to spontaneously control VIH infection in the absence of therapy, with plasma viral loads below 50 RNA copies/ml and that constitute the 5% of the infected population), viremic controllers (with PVLs higher than 50 and lower than 5000 RNA copies/ml without therapy), viremic non-controllers (with PVLs higher than 5000 RNA copies/ml without therapy) and patients with antiretroviral therapy (HAART). All patients had CD4 T cell counts higher than 450 cell/mm3. Results revealed that immature dendritic cells from HIV-infected patients who control the infection produced higher levels of α-defensins1-3 than the non-infected control group and these levels were associated with a better control of HIV infection and slower disease progression. The study of controller patients, especially elite controllers, is of particular relevance since these individuals demonstrate that natural control of HIV replication in the absence of antiretroviral therapy is possible.

The findings of this study show that of α-defensins1-3 may be potential prophylactic agents and open a new line of investigation to treat HIV / AIDS, although further studies will be needed to determine the possible value of these molecules as an important diagnostic and therapeutic tool to arrest or slow the replication of HIV in infected patients.

]]> http://blog.hospitalclinic.org/en/2010/02/identifiquen-factors-dimmunitat-natural-que-controlen-la-progressio-de-la-malaltia-en-pacients-seropositius/feed/ http://blog.hospitalclinic.org/en/2010/02/barcelona-forma-part-d%e2%80%99una-investigacio-mundial-contra-la-tuberculosi-barcelona-forma-parte-de-una-investigacion-mundial-contra-la-tuberculosis/ http://blog.hospitalclinic.org/en/2010/02/barcelona-forma-part-d%e2%80%99una-investigacio-mundial-contra-la-tuberculosi-barcelona-forma-parte-de-una-investigacion-mundial-contra-la-tuberculosis/#comments Tue, 09 Feb 2010 12:44:32 +0000 Direcció de Comunicació Corporativa http://blog.hospitalclinic.org/?p=2868

The Tuberculosis Trials Consortium (TBTC) strives to conduct research about the diagnosis, medical treatment, and prevention of tuberculosis (TB) infection and disease. The network is composed of a partnership of clinical investigators from the U.S. Centers for Disease Control and Prevention (CDC), public health departments from different countries, as well as medical and pharmaceutical institutions. From now and until 2010, this Consortium will receive more than $90 million to develop more effective tuberculosis treatments. This funding will be distributed among 20 selected research sites, being Barcelona the only European representative: this site will be coordinated by Dr. Joan A. Caylà, from the Barcelona Public Health Agency (ASPB), and Dr. Josep Maria Miró, from Hospital Clínic de Barcelona - IDIBAPS and the Department of Medicine at the UB. Other participating institutions will be Hospital del Mar, Hospital de Sant Pau, Hospital Universitari MútuaTerrassa, Hospital de Bellvitge, Hospital Vall d’Hebron and the Tuberculosis Control Unit at Drassanes Primary Care Centre within the framework of the Tuberculosis Investigation Unit of Barcelona (UITB).

Over the next 10 years (2010-2020), an international research effort, based on clinical trials with patients, will be carried out. Countries like Brazil, Peru, Spain, South Africa, Uganda, Kenya, Vietnam, the Philippines and China (Hong Kong) will collaborate in this global network though their research sites. The research group at the TBTC will also include 7 sites in the United States.

Tuberculosis is a communicable disease caused by Mycobacterium tuberculosis. It usually affects the lungs, but can also affect other parts of the body, such as the brain, kidneys, or spine. According to the World Health Organization estimates, almost one third of the world’s population (2.000 million people) is infected by the disease-causing bacterium. However, the active disease will only develop in certain people, such as those ones with an immune system facing situations such as a transplant, HIV or malnutrition. More than 9 million people around the world become sick with tuberculosis, and almost 2 million die each year.

There are many challenges such as the irregular access to TB diagnosis and treatment, HIV co-infection, the emergence of resistances and the extremely drug-resistant tuberculosis. This latter form of the disease does not respond to first or second-line drugs, the treatment options are very limited and the risk of death is very high. In addition, compliance with a program for tuberculosis requires at least six months of treatment. Therefore, the search for new diagnostic tests, medicines, vaccines and protocols, as well as reducing the duration of treatment, is more necessary than ever.

TBTC has undertaken 9 major trials and 15 sub-studies. Most recently, TBTC study findings have influenced guidelines for treating people co-infected with TB and HIV. CDC conducted their first open competition for a group of TB researchers in 1993.

More than 12.000 patients

TBTC conducts a series of clinical trials with more than 12.000 patients and volunteers enrolled and an annual operating budget of approximately $10 million. With the commitment and support of CDC, the Consortium provides a global network for these trials and plays an important role in improving the treatment of tuberculosis, its control and prevention. Currently, TBTC is completing a study for an innovative treatment for latent tuberculosis infection, and has begun its first clinical trial in patients with multiresistant tuberculosis.

Tuberculosis in our environment

Tuberculosis is an infectocontagious disease that can be fatal if not treated. In Barcelona it has a low and decreasing incidence, but 400 new cases are recorded annually. In the case of Catalonia, the annually recorded new cases amount to 1.600.

The scientific community is working to develop new and more effective drugs against tuberculosis because the ones that are currently available require many months of treatment. In addition, research is necessary to cope with extremely resistant tuberculosis, which begins to be quite common today. With its participation in CDC’s Tuberculosis Trials Consortium, Barcelona becomes the European capital of tuberculosis.

The Official Medical College of Barcelona, Keiretsu Forum Barcelona and Barcelona Activa organized last November 4, 2009 the 1st Healthcare Investment Forum Barcelona’09, in collaboration with Biocat and other institutions. The objective of this forum was to contact young entrepreneurs in the health sector with projects in biotechnology, medical devices, health services and information technology with venture capital investors interested in this sector.

This first edition of the Forum was a success. Over 35 companies presented their projects, of which 12 were finally selected. Three of the finalists were submitted by Hospital Clinic:

Transmural Biotech. Led by Dr. Eduard Gratacós (Fetal Medicine) and Ivan Amat (Bioengineering) aims to develop medical technology solutions in the field of fetal medicine and therapy.

Immunovative Developments. Led by Dr. Francisco Lozano, this spin-off is dedicated to the development of new biological therapies in the field of sepsis and inflammatory diseases with immunological basis.

Bionure. Led by Dr. Pablo Villoslada, it aims to develop innovative therapy for multiple sclerosis.

The Carlos III Health Institute, a public body under the Ministry of Science and Innovation, has created two new stable cooperative research structures to boost Biobanks and Innovation in Spanish centers. The Hospital participates in these two initiatives, as well as in most of the already operating CIBERs i RETICS.

The RETICS (Cooperative Thematic Networks in Biomedical Research) have an expected duration of 4 years and consist of professionals from different institutions. They aim to promote complementarity of activities, resource sharing and lines of research, development and innovation. The two new structures established this year are the RETICS of Biobanks and the RETICS of Innovation in Medical and Health Technologies.

Biobanks are a key element in translational biomedical research today and will help redefine diseases according to their genetic and molecular bases and enhance preventive and individualized medicine.

This new challenge for innovative collaborative research, coinciding with the European Year of Creativity and Innovation, will allow the Clínic to promote the collaboration with many groups nationwide. It involves a strong commitment for translational and collaborative research of quality, in the line of the most advanced biomedical research countries and a new step towards research excellence.

The largest international clinical trial to date into a preventative HIV gel has found no evidence that the vaginal microbicide, PRO 2000, reduces the risk of HIV infection in women, scientists announced today. This placebo-controlled trial involved 9,385 women at six research centres in four African countries and found that the risk of HIV infection in women who were supplied with PRO 2000 gel was not significantly different than in women supplied with placebo gel. Although ineffective in providing protection, PRO 2000 gel itself was safe to use.

A vaginal microbicide is a product intended for use before sexual intercourse to help reduce HIV infection, as it is clear that condom promotion alone has not controlled the epidemic. The gel was given to participants together with a package of prevention against HIV infection that included free condoms, counselling for safer sex negotiation and sexual health throughout the trial.

The trial, known as MDP 301, took place between September 2005 and September 2009 and was carried out by the Microbicides Development Programme (MDP), a not-for-profit partnership of 16 African and European research institutions. It was funded by the UK Department for International Development (DFID) and the UK Medical Research Council (MRC).

To date, no microbicide has been shown to be effective against HIV infection. This trial shows conclusively that PRO 2000 gel is of no added benefit, ending scientific speculation about its clinical importance.

MDP 301 Chief Investigator, Dr Sheena McCormack of the Medical Research Council said: “This result is disheartening; particularly in light of the results of a smaller trial sponsored by the US National Institutes of Health (NIH) which suggested that PRO 2000 could reduce the risk of HIV infection by 30 per cent. Nevertheless we know this is an important result and it shows clearly the need to undertake trials which are large enough to provide definitive evidence for whether or not a product works.”

Professor Jonathan Weber, co-Chair of the MDP Programme Management Board from the Division of Medicine at Imperial College London, said: “This is a disappointing result for the product, as the trial shows that it is not effective. However, the trial itself was very well designed and undertaken, so we know that the results are definitive.

“It is unfortunate that this microbicide is ineffective at preventing HIV infection, but it’s still vital for us as scientists to continue to look for new ways of preventing HIV. There are many research groups exploring different avenues to tackle HIV; it is a slow process, but we are making progress. Now that we know this microbicide is not the answer, we can concentrate on other treatments that might be.”

Dr Maureen Chisembele, Principal Investigator of the Zambian site, said: “In Sub-Saharan Africa, nearly 60 per cent of all people living with HIV/AIDS are women. Many are highly vulnerable to HIV despite the fact that they are faithful to their partners. The women will be disappointed by this result as they really liked the gel and hoped it would work.”

A South African trial participant commented: “Even though the gel proved not to be effective, we played a role in the fight against HIV. We learnt a lot about caring for ourselves, such as using condoms. We also learnt to encourage others to test for HIV and we gained confidence in helping those who were already infected.”

CRESIB (Hospital Clínic de Barcelona - Universitat de Barcelona) investigator, Dr. Robert Pool, was the coordinator of the social science component of the study: “This trial had the largest and most detailed social science component that has ever been used in a clinical trial and involved the use of mixed-methods to collect more accurate data on sexual behaviour and adherence, which is crucial in such clinical trials. The social science component also focused verifying participants’ understanding of the trial and assessing acceptability. Although our centre at Manhiça is part of the Microbicide Development Programme, they were not part of this trial. Currently, together with Dra Khatia Munguambe and Dr Sibone Micumbi and their team in Mahiça, we are conducting feasibility studies for the next trial”.

The trial participants are being informed of the trial outcome. The full results will be submitted for presentation at international conferences in 2010, as well as for publication in a peer-reviewed scientific journal.

The gel used in the study was provided by Endo Pharmaceuticals, a specialty pharmaceutical company with headquarters in Chadds Ford, Pennsylvania, USA.

More information about the MDP 301 microbicides trial can be found at http://www.mdp.mrc.ac.uk/

Performing surgical operations without leaving scars has ceased to be a chimera and has become a reality. This is demonstrated by the recent surgical advances made using NOTES (Natural Orifice Transluminal Endoscopy Surgery), an innovative surgical approach that allows surgical access using the body’s natural orifices. The results are all advantageous for the patient: lack of scars, shorter hospital stay and faster recovery. Currently, this type of minimally-invasive surgery is still in the research and development stage. Surgery through the mouth and vagina has been successfully used, but the transanal route (through the anus) is less utilized.

On November 9 2009, a team of surgeons carried out the first surgical removal of a rectal mass using the NOTES approach and TEM (Transanal Endoscopic Microsurgery) technique in the Hospital Clinic of Barcelona. The successful (deleted outcome) surgery was due to a collaboration between the Gastrointestinal Surgery team of the Hospital Clinic, headed by Dr. Antonio Mª de Lacy, and a team of surgeons from the Massachusetts General Hospital of Boston (Harvard University), headed by Dr. Patricia Sylla, Instructor of Surgery at the Harvard Medical School. This is the first time in the world that a rectal tumor has been excised using an approach through the anus.

The patient, a 76-year-old woman diagnosed with a malignant rectal tumor, was discharged home with no complications and excellent postoperative recovery on November 14 - only five days after surgery. During the operation, nearly all surgical instruments were introduced through the anus to avoid painful abdominal incisions. This new technique has been developed to achieve better results than laparoscopic surgery, and is a minimally-invasive technique with many advantages: less pain, shorter hospital stay and safe oncologic results. Thanks to the joint work of this international team of experts, surgery has taken a step forward, with a successful operation to excise a rectal mass without leaving surgical scars, whereas even laparoscopic surgery requires four or five minimal incisions.

Transanal Endoscopic Microsurgery (TEM) has many advantages

The transanal route presents many advantages. One essential point is that it can be used in both men and women, unlike the transvaginal route (through the vagina). Another advantage is the possibility of opening and closing the colon or rectum under direct vision. This is possible due to the use of techniques developed for the local treatment of rectal lesions, known as Transanal Endoscopic Microsurgery (TEM).

The TEM technique uses rectal endoscopy to introduce a specially-designed proctoscope connected to a CO2 insufflation system that dilates the rectum. This creates a working space that allows the instruments required to section and dissect the mass to be introduced. This route allows the dissection of the rectum and surrounding tissue until the abdominal cavity is reached, a wholly innovative technique.

The importance of international collaboration between hospitals

This landmark surgery, presented simultaneously today in the Hospital Clinic of Barcelona and Massachusetts General Hospital, was made possible due to the experience of the two surgical teams, who both specialize in minimally-invasive surgical approaches to treat diseases of the colon and rectum. Dr. Lacy has played a fundamental role in the widespread application of laparoscopic surgery, using small incisions in the abdomen, to treat colorectal cancer. Dr. Sylla has been developing techniques for application in colorectal surgery since 2007 in collaboration with Dr. David Rattner, Professor of Surgery at the Massachusetts General Hospital and Harvard Medical School, an authority on NOTES and co-founder of NOSCAR (Natural Orifice Surgery Consortium for Assessment and Research).

After demonstrating the safety and efficiency of the TEM technique in pigs, the two teams carried out studies on human cadavers. Unlike other NOTES procedures, which require incisions in order to access the surgical field, the transanal approach is the only route where the tissue perforated to gain access to the diseased area is part of the tissuethat will ultimately be excised.

In the future, this new technique will be available to treat other diseases of the colon and rectum.

Dr. Lacy states: “We are convinced that this type of surgery will bring additional advantages to those already shown by laparoscopic surgery, reducing surgical invasiveness by eliminating abdominal incisions, and resulting in fewer postoperative complications and a speedier recovery”.

Dr. Sylla states: “Based on this first case, I am encouraged that in the near future we will be able to offer this type of procedure to more patients. This approach could have wide use for patients with colorectal cancer, diverticulitis, and other diseases of the colon and rectum.”

Although progress is being made in reducing the number of child deaths each year, pneumonia still kills more children than any other disease.

Fight pneumonia, safe a child, is the motto for the World Pneumonia Day, a day for the world to focus on the disease that kills more children than any other, pneumonia.

Pneumonia kills more than 4 million people each year including over 2 million children younger than five years old. Pneumonia kills more children than AIDS, measles, and malaria combined, and yet many children do not receive affordable solutions proven to prevent and control pneumonia.

A simple three-pronged solution has the potential to save more than a million children every year: Protect, prevent and treat. Programs should protect children by promoting exclusive breast feeding for the first six months of life. Vaccination programs in countries where children die of pneumonia should include immunizations that prevent the major causes of pneumonia deaths. Pertussis and measles are already in most national programs. Vaccines against pneumococcus and Hib, estimated to cause more than 50% of deadly pneumonia, should be added as soon as possible. Health providers must also quickly diagnose and treat children who do become ill with appropriate antibiotics.

Efforts to significantly reduce this syndrome require a multi-faceted effort and coordinated approach from various parts of government and a variety of global, regional, and local stakeholders. Working together, these groups need to implement and/or strengthen policies addressing pneumonia, monitor progress, and provide the resources needed to ensure programs reach the children in need. An important first step is to focus the world’s attention on pneumonia and to make policy makers aware of the burden of pneumonia and its solutions. This effort requires a broad commitment from many.

If we work together, we can make sure that the world recognizes that we have the tools today and that now is the time to take on pneumonia.

More information http://worldpneumoniaday.org/

A study published in the August 1 issue of the Journal of Infectious Diseases has shown for the first time that RTS,S, the world’s most clinically advanced malaria vaccine candidate, maintains protection during a 45 month follow-up period. The study conducted in 2022 Mozambican children age 1-4 years demonstrates that the RTS,S/AS02 vaccine is capable of reducing clinical episodes of malaria by 30 percent and severe malaria cases by 38 percent for at least 45 months following its administration.

Today, Dr. Pedro L. Alonso, director of both the International Health Research Centre of Barcelona (CRESIB – Hospital Clinic – University of Barcelona) and the Manhiça Centre of Health Research, presented during the Biocat Conference on Research and Challenges in Global Health the results published in the Journal of Infectious Diseases. This is a joint initiative of the Bioregion of Catalonia (Biocat), CRESIB, Fundació Clínic for Biomedical Research and “la Caixa” Foundation, with the aim of stimulating debate among worldwide experts in international health.

“This present study reports what is, to our knowledge, the first long-term follow-up of a paediatric malaria vaccine trial in Africa,” stated Dr. Alonso today. “This is significant because it suggests the vaccine candidate may allow young children who are most susceptible to malaria the opportunity to build natural defences against the disease and thus fight infection more effectively. This could eventually avert tens of millions of cases of malaria and potentially save hundreds of thousands of lives.”

Malaria control is one of the most challenging issues facing the public health community. Malaria is endemic in 80 countries, where an estimated 250 million cases are reported every year. Despite current control efforts using other interventions, such as bed nets and effective drug therapies, malaria still kills approximately 900,000 people every year, with most deaths occurring in Africa among children under the age of five.

GlaxoSmithKline Biologicals’ RTS,S is the first malaria vaccine candidate to demonstrate significant efficacy along with a clinically acceptable safety profile to warrant Phase III clinical testing and is the leading candidate in efforts supported by the PATH Malaria Vaccine Initiative (MVI) to develop a malaria vaccine.

Among additional Phase II studies conducted in other countries in Africa, the Mozambican study is an important step in the development of an effective malaria vaccine. Research teams in Barcelona and Mozambique previously published the first conclusive evidence that RTS,S is capable of triggering a protective immune response to malaria in African children (Alonso et al., Lancet 2004) and that its efficacy could last for up to 18 months (Alonso et al., Lancet 2005). Their latest paper demonstrates that the vaccine is capable of inducing long-term protection against malaria for up to 45 months following its administration (Sacarlal et al., J. Infect Dis. 2009).

“The Mozambican data, consistent with our other Phase II study results, build a strong rationale for large-scale advanced trials in Africa,” continued Alonso. “We are proud of the role Mozambique scientists and our local communities have played in the development of a vaccine that could significantly relieve the burden of the disease throughout the continent.”

The Phase III trial of RTS,S, already started, will enrol up to 16,000 children at 11 sites in seven African countries, namely Mozambique, Tanzania, Burkina Faso, Gabon, Ghana, Kenya and Malawi. The new study is expected to confirm the efficacy and safety profile of RTS,S in a large cohort of children.

More information in other official sources:

Wold Health Organization

A third (30%) of malaria cases can be avoided in African infants using a safe, affordable and simple tool called Intermittent Preventive Treatment of malaria in Infants (IPTi) with the medicine sulfadoxine-pyrimethamine (SP), which can be delivered alongside existing childhood vaccination programmes.

Results of a meta-analysis examining six clinical trials in Africa for the malaria intervention which the World Health Organization already recommends, are published in the medical journal, The Lancet. Authors of this study and CRESIB (Hospital Clínic-Universitat de Barcelona) researchers Drs. Clara Menéndez, John Aponte and Andrea Egan (from left to right in the picture), explained the results obtained in this global analysis during a press conference in Barcelona. Research experts say if IPTi-SP were expanded in other African countries, 6 million cases of malaria could be prevented each year in those most vulnerable to the disease.

“These results confirm the potential for IPTi using SP, which can be easily and rapidly implemented via existing WHO immunisation programmes, saving tens of thousands of lives every year across Africa,” commented Dr. Clara Menéndez, principal investigator who lead the study. Dr. Pedro L. ALonso, head of the Secretariat of the IPTi Consortium at CRESIB (Hospital Clínic-Universitat de Barcelona), added: “IPTi provides a valuable addition to efforts to fight malaria and so international policy-makers and heads of national Malaria Control Programmes should consider its immediate adoption and integration into existing programmes”.

Organised by the IPTi Consortium and supporting partners – a unique collaboration of more than 20 organisations in Africa, Europe and the United States – the pooled analysis of six randomised, placebo-controlled trials of IPTi-SP in Africa provides the best evidence to date that this approach is effective in preventing malaria in infants. The study analysed results from nearly 8,000 infants, in four African countries, over nine years, between 1999-2008. The efficacy results were re-analysed by the statistician of each of the six trials, and an independent panel made up of experts in safety and pharmacovigilance in Africa conducted an analysis of the safety. The IPTi Consortium is supported by the Bill & Melinda Gates Foundation.

UNICEF’s Operational Research Coordinator, Dr. Alexandra de Sousa, stated “UNICEF supports IPTi implementation scale up in Africa, a new intervention in the control of malaria with the potential to significantly reduce child illness”.

A separate study in Northern Tanzania shows that in areas of very high resistance to the medication, IPTi with SP is not efficacious and alternative anti-malarial drugs are needed. The long-acting medicine mefloquine was seen to reduce the incidence of clinical malaria in infants in the first year of life by 38%.  For the long term, it is important that research is accelerated to develop additional drugs for use with IPTi in different settings and in different circumstances, especially in areas where parasite resistance is a problem.

Malaria represents an important public health burden in Africa, disproportionately affecting the youngest and most vulnerable. Of the 247 million cases of malaria worldwide in 2006, 86% occurred in Africa, among which, African infants are at most risk of the worst forms of malaria. Every 30 seconds an African child dies from malaria.

About IPTi

IPTi is the administration of an anti-malarial tablet to infants, two or three times in the first year of life, deliverable alongside established vaccination programmes such as WHO’s Expanded Programme for Immunisation.  It is inexpensive (each dose costs between USD $0.13 - $0.23) and cost effective.

IPTi with SP has been reviewed by a committee of the US National Academy of Sciences’ Institute of Medicine and the World Health Organization’s Technical Expert Group – these committees recommend that it should be considered for implementation in areas of moderate to high levels of malaria transmission and low to moderate levels of parasite resistance to SP.

About the trials in the pooled analysis

Trials were conducted in Mozambique, Gabon, Tanzania and Ghana involving the following organisations in Africa and Europe: Barcelona Centre for International Health Research, Spain; Centro de Investigação em Saude de Manhiça, Mozambique; University of Tübingen, Germany; Ifakara Health Research Development Centre, Tanzania; University of Witwatersrand, Johannesburg, South Africa; Institute of Tropical Medicine and International Health, Charité, University Medicine Berlin, Germany; Kintampo Health Research Centre, Ghana Health Service/Ministry of Health, Ghana; London School of Hygiene and Tropical Medicine, London, UK; Albert Schweitzer Hospital, Lambaréné, Gabon; Ministry of Health/Ghana Health Service; Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Swiss Tropical Institute, Basel, Switzerland.

About the trial in Northern Tanzania

The trial was conducted in two sites in northern Tanzania, Korogwe and Same, by the following organisations; Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; the National Institute for Medical Research, Tanga Centre, Tanga, Tanzania; and the Kilimanjaro Christian Medical College, Moshi, Tanzania.

About the IPTi Consortium

The IPTi Consortium’s Secretariat was the Barcelona Centre for International Health Research, Hospital Clinic, University of Barcelona, headed by Dr. Pedro L. Alonso. The IPTi Consortium consists of leading centres of malaria research in Africa, Europe, United States and Papua New Guinea including the Albert Schweitzer Hospital, Lambaréné, Gabon; Barcelona Centre for International Health Research, Hospital Clinic, University of Barcelona, Spain; Case Western Reserve University, Cleveland, USA; Centers for Disease Control and Prevention, Atlanta, USA; Ifakara Health Research and Development Centre, Ifakara, Tanzania; Institut de Recherche pour le Développement, Dakar, Sénégal; Kenya Medical Research Institute, Kisumu, Kenya; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; London School of Hygiene and Tropical Medicine, London, UK; Manhiça Health Research Centre, Manhiça, Mozambique; National Institute for Medical Research, Amani, Tanzania; PNG Institute of Medical Research, Goroka, Papua New Guinea; Swiss Tropical Institute, Basel, Switzerland; Université Cheikh Anta Diop de Dakar, Dakar, Sénégal; University of Copenhagen, Copenhagen, Denmark; University of Tübingen, Tübingen, Germany; Walter and Eliza Hall Institute of Medical Research, University of Melbourne, Australia; World Health Organization (WHO); United Nations Children’s Fund (UNICEF).