@article{Phiri2021-oy,

title = {The duration of protection from azithromycin against malaria,  acute respiratory, gastrointestinal, and skin infections when  given alongside seasonal malaria chemoprevention: Secondary  analyses of data from a clinical trial in hound\'{e}, Burkina  Faso, and bougouni, Mali},

author = {Mphatso Dennis Phiri and Matthew Cairns and Issaka Zongo and Frederic Nikiema and Modibo Diarra and Rakiswend\'{e} Serge Yerbanga and Amadou Barry and Amadou Tapily and Samba Coumare and Ismaila Thera and Irene Kuepfer and Paul Milligan and Halidou Tinto and Alassane Dicko and Jean Bosco Ou\'{e}draogo and Brian Greenwood and Daniel Chandramohan and Issaka Sagara},

doi = {10.1093/cid/ciaa1905},

issn = {1537-6591 1058-4838},

year  = {2021},

date = {2021-10-01},

urldate = {2021-10-01},

journal = {Clin. Infect. Dis.},

volume = {73},

number = {7},

pages = {e2379--e2386},

publisher = {Oxford University Press (OUP)},

abstract = {BACKGROUND: Mass drug administration (MDA) with azithromycin 

 (AZ) is being considered as a strategy to promote child survival 

 in sub-Saharan Africa, but the mechanism by which AZ reduces 

 mortality is unclear. To better understand the nature and extent 

 of protection provided by AZ, we explored the profile of 

 protection by time since administration, using data from a 

 household-randomized, placebo-controlled trial in Burkina Faso 

 and Mali. METHODS: Between 2014 and 2016, 30 977 children aged 

 3-59 months received seasonal malaria chemoprevention (SMC) with 

 sulfadoxine-pyrimethamine plus amodiaquine and either AZ or 

 placebo monthly, on 4 occasions each year. Poisson regression 

 with gamma-distributed random effects, accounting for the 

 household randomization and within-individual clustering of 

 illness episodes, was used to compare incidence of prespecified 

 outcomes between SMC+AZ versus SMC+placebo groups in fixed time 

 strata post-treatment. The likelihood ratio test was used to 

 assess evidence for a time-treatment group interaction. RESULTS: 

 Relative to SMC+placebo, there was no evidence of protection 

 from SMC+AZ against hospital admissions and deaths. Additional 

 protection from SMC+AZ against malaria was confined to the first 

 2 weeks post-administration (protective efficacy (PE): 24.2% 

 [95% CI: 17.8%, 30.1%]). Gastroenteritis and pneumonia were 

 reduced by 29.9% [21.7; 37.3%], and 34.3% [14.9; 49.3%], 

 respectively, in the first 2 weeks postadministration. 

 Protection against nonmalaria fevers with a skin condition 

 persisted up to 28 days: PE: 46.3% [35.1; 55.6%]. CONCLUSIONS: 

 The benefits of AZ-MDA are broad-ranging but short-lived. To 

 maximize impact, timing of AZ-MDA must address the challenge of 

 targeting asynchronous morbidity and mortality peaks from 

 different causes.},

note = {© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.

PMID: 33417683 

PMCID: PMC8492219},

keywords = {Antimalarials/therapeutic use, Azithromycin, Azithromycin/therapeutic use, Burkina Faso/epidemiology, Chemoprevention, Child, child mortality, Drug Combinations, duration of protection, Humans, Infant, Malaria/drug therapy/epidemiology/prevention \& control, Mali/epidemiology, Preschool, Sahel, seasonal malaria chemoprevention, Seasons},

pubstate = {published},

tppubtype = {article}

}

@article{Ouedraogo2020-vc,

title = {A microplanning model to improve door-to-door health service  delivery: the case of Seasonal Malaria Chemoprevention in  Sub-Saharan African villages},

author = {Andr\'{e} Lin Ou\'{e}draogo and Julie Zhang and Halidou Tinto and Innocent Val\'{e}a and Edward A Wenger},

doi = {10.1186/s12913-020-05972-2},

issn = {1472-6963},

year  = {2020},

date = {2020-12-07},

urldate = {2020-12-01},

journal = {BMC Health Serv. Res.},

volume = {20},

number = {1},

pages = {1128},

publisher = {Springer Science and Business Media LLC},

abstract = {BACKGROUND: Malaria incidence has plateaued in Sub-Saharan 

 Africa despite Seasonal Malaria Chemoprevention's (SMC) 

 introduction. Community health workers (CHW) use a door-to-door 

 delivery strategy to treat children with SMC drugs, but for SMC 

 to be as effective as in clinical trials, coverage must be high 

 over successive seasons. METHODS: We developed and used a 

 microplanning model that utilizes population raster to estimate 

 population size, generates optimal households visit itinerary, 

 and quantifies SMC coverage based on CHWs' time investment for 

 treatment and walking. CHWs' performance under current SMC 

 deployment mode was assessed using CHWs' tracking data and 

 compared to microplanning in villages with varying demographics 

 and geographies. RESULTS: Estimates showed that microplanning 

 significantly reduces CHWs' walking distance by 25%, increases 

 the number of visited households by 36% (p \< 0.001) and 

 increases SMC coverage by 21% from 37.3% under current SMC 

 deployment mode up to 58.3% under microplanning (p \< 0.001). 

 Optimal visit itinerary alone increased SMC coverage up to 100% 

 in small villages whereas in larger or hard-to-reach villages, 

 filling the gap additionally needed an optimization of the CHW 

 ratio. CONCLUSION: We estimate that for a pair of CHWs, the 

 daily optimal number of visited children (assuming 8.5mn spent 

 per child) and walking distance should not exceed 45 (95% CI 

 27-62) and 5 km (95% CI 3.2-6.2) respectively. Our work 

 contributes to extend SMC coverage by 21-63% and may have 

 broader applicability for other community health programs.},

note = {PMID: 33287825 

PMCID: PMC7720067},

keywords = {Africa South of the Sahara/epidemiology, Antimalarials/therapeutic use, Burkina Faso, Chemoprevention, Child, CHW, Community health worker, Door-to-door, Health Services, Humans, Malaria, Malaria/drug therapy/epidemiology/prevention \& control, Microplanning, Model, Satellite imagerySeasonal malaria chemoprevention, Seasons, SMC},

pubstate = {published},

tppubtype = {article}

}