The committee found that the cumulative data supporting an effect on hospitalization with malaria parasites, anemia and all-cause hospitalization were more modest and less consistent across the trials than the effect on episodes of clinical malaria (Table 18). The committee found the efficacy estimates for these additional outcomes to be encouraging but less robust than the cumulative data for efficacy against clinical malaria. Accordingly, the committee remained cautious in drawing conclusions concerning the effect of IPTi-SP in preventing these other outcomes. The analyses from randomization through 5 months after the last dose of IPTi-SP leave open the possibility that studies with much larger sample sizes might have demonstrated a statistically more convincing protective effect.

Depending on the specific outcome event measured, the committee found mixed evidence regarding the existence of a rebound. In no case was the rebound sufficiently large to negate the overall benefit of IPTi-SP. Based on its review of all the data and the analyses presented, the committee concluded that the extent of rebound is small and that the benefits of IPTi-SP outweigh this negative effect.