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Table 1 Summary of potential uses for injectable prophylactic medicines

From: Injectable anti-malarials revisited: discovery and development of new agents to protect against malaria

Use case

Description

Target population

Comments

(1) Travellers

Residents of regions of very low or no malaria incidence travelling to malaria endemic areas

Initially, all adults and children > 5 years

Increasing numbers of travellers within Africa, given increased GDP; increasing numbers of Africans in areas of low transmission

(2a) Malaria epidemic

Re-emergence of malaria in zones which had been previously declared malaria free

Entire population

Need demonstration of safety in first trimester of pregnancy; deployment during ‘maintaining zero’

(2b) Febrile epidemic

Protection of a population from malaria during epidemics such as Ebola

Entire population

Need demonstration of safety in first trimester of pregnancy. Currently maintained as monthly ACT. Value only if injections offer longer protection

(3) Protection from infection of subjects in high transmission zones

Replacing the SMC regimens of monthly protection by SP-AQ given currently to children under 5 in the Sahel with true chemoprotection

Children < 10 years

No requirement for safety demonstration in first trimester of pregnancy; combination would ideally have causal prophylaxis (preventing blood-stage and liver stage activity)