Is the Expanded Programme on Immunisation the most appropriate delivery system for intermittent preventive treatment of malaria in West Africa?

OBJECTIVE: To investigate the coverage and equity of the Expanded Programme on Immunisation (EPI) and its effect on age schedule, seasonality of malaria risk, and linked intermittent preventive treatment (IPT) in West Africa. METHOD: Secondary analyses of data from a trial of IPT in Ghana. The potential effectiveness and impact of EPI-linked IPT in West Africa was calculated using the coverage of Diptheria Pertussis Tetanus vaccination obtained from national surveys and the reported protective efficacies of IPT. RESULTS: In West Africa, where the transmission of malaria is highly seasonal, only 10% of malaria episodes in infants would be averted with the current coverage of EPI. CONCLUSION: In this setting, the EPI-linked IPT is not necessarily the most appropriate approach and alternative IPT schedules and delivery systems are needed.