Implementation and effectiveness of intermittent preventive treatment in school aged children using dihydroartemisinin-piperaquine to reduce malaria burden: an implementation research of a cluster randomised trial in Tanzania.

In low-prevalence strata, the intervention's effect did not reach statistical significance, likely due to limited baseline malaria prevalence, though the protective efficacy observed remains relevant.

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In the course of one year (month 12) of intervention implementation, in a linear mixed model, there were changes from baseline in haemoglobin levels (Hb) among participants in the intervention arm compared to those in control arm (0.31 g/dL, 95% CI: 0.2–0.4, p < 0.001), this was on individual participant but fell short of significance on cluster adjustment ( Supplementary Table S3 ).

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The effect was more pronounced in high-transmission strata (PE = 56%, 95% CI: 36.3–69.5; NNT = 53), with incidence falling from 0.03 to 0.01 cases per child-month, compared with a smaller and borderline significant reduction in low-transmission strata (PE = 30%, 95% CI: −1.4–51.4).

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