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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)