2024 |
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Kadiatou Koita, Joel D. Bognini, Efundem Agboraw, Mahamadou Dembélé, Seydou Yabré, Biébo Bihoun, Oumou Coulibaly, Hamidou Niangaly, Jean Batiste N’Takpé, Maia Lesosky, Dario Scaramuzzi, Eve Worrall, Jenny Hill, Valérie Briand, Halidou Tinto, Kassoum Kayentao Increasing the uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) through seasonal malaria chemoprevention channel delivery: protocol of a multicenter cluster randomized implementation trial in Mali and Burkina Faso Journal Article In: BMC public health, vol. 24, iss. 1, 2024, ISSN: 1471-2458. Abstract | BibTeX | Tags: Antimalarials* / therapeutic use, Burkina Faso, Chemoprevention, Child, Clinical Trial Protocol, doi:10.1186/s12889-023-17529-z, Drug Combinations, Female, Humans, Joel D Bognini, Kadiatou Koita, Kassoum Kayentao, Malaria* / drug therapy, Malaria* / prevention & control, Mali, MEDLINE, Multicenter Studies as Topic, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Non-U.S. Gov't, Parasitic* / prevention & control, PMC10763117, pmid:38166711, Pregnancy, Pregnancy Complications, Preschool, PubMed Abstract, Pyrimethamine / therapeutic use, Randomized Controlled Trials as Topic, Research Support, Seasons, Sulfadoxine / therapeutic use | Links: @article{Koita2024, Background: The uptake of Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine-Pyrimethamine (IPTp-SP) remains unacceptably low, with more than two-thirds of pregnant women in sub-Saharan Africa still not accessing the three or more doses recommended by the World Health Organisation (WHO). In contrast, the coverage of Seasonal Malaria Chemoprevention (SMC), a more recent strategy recommended by the WHO for malaria prevention in children under five years living in Sahelian countries with seasonal transmission, including Mali and Burkina-Faso, is high (up to 90%). We hypothesized that IPTp-SP delivery to pregnant women through SMC alongside antenatal care (ANC) will increase IPTp-SP coverage, boost ANC attendance, and increase public health impact. This protocol describes the approach to assess acceptability, feasibility, effectiveness, and cost-effectiveness of the integrated strategy. Methods and analysis: This is a multicentre, cluster-randomized, implementation trial of IPTp-SP delivery through ANC + SMC vs ANC alone in 40 health facilities and their catchment populations (20 clusters per arm). The intervention will consist of monthly administration of IPTp-SP through four monthly rounds of SMC during the malaria transmission season (July to October), for two consecutive years. Effectiveness of the strategy to increase coverage of three or more doses of IPTp-SP (IPTp3 +) will be assessed using household surveys and ANC exit interviews. Statistical analysis of IPT3 + and four or more ANC uptake will use a generalized linear mixed model. Feasibility and acceptability will be assessed through in-depth interviews and focus group discussions with health workers, pregnant women, and women with a child < 12 months. Discussion: This multicentre cluster randomized implementation trial powered to detect a 45% and 22% increase in IPTp-SP3 + uptake in Mali and Burkina-Faso, respectively, will generate evidence on the feasibility, acceptability, effectiveness, and cost-effectiveness of IPTp-SP delivered through the ANC + SMC channel. The intervention is designed to facilitate scalability and translation into policy by leveraging existing resources, while strengthening local capacities in research, health, and community institutions. Findings will inform the local national malaria control policies. Trial registration: Retrospectively registered on August 11th, 2022; registration # PACTR202208844472053. Protocol v4.0 dated September 04, 2023. Trail sponsor: University of Sciences Techniques and Technologies of Bamako (USTTB), Mali. | |||
Marc Christian Tahita, Quique Bassat Post-discharge malaria chemoprevention in children with severe anaemia: a robust strategy to save lives Journal Article In: The Lancet. Global health, vol. 12, iss. 1, pp. e2-e3, 2024, ISSN: 2214-109X. BibTeX | Tags: Aftercare, Anemia* / epidemiology, Anemia* / prevention & control, Antimalarials* / therapeutic use, Chemoprevention, Child, Humans, Infant, Malaria* / drug therapy, Malaria* / prevention & control, Marc Christian Tahita, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Patient Discharge, pmid:38097287, PubMed Abstract, Quique Bassat | Links: @article{Tahita2024, | |||
2023 |
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Paul Sondo, Bérenger Kaboré, Toussaint Rouamba, Eulalie Compaoré, Yssimini Nadège Guillène Tibiri, Hyacinthe Abd El Latif Faïçal Kaboré, Karim Derra, Marc Christian Tahita, Hamidou Ilboudo, Gauthier Tougri, Ismaïla Bouda, Tikanou Dakyo, Hyacinthe Kafando, Florence Ouédraogo, Eli Rouamba, So Franck Hien, Adama Kazienga, Cheick Saïd Compaoré, Estelle Bambara, Macaire Nana, Prabin Dahal, Franck Garanet, William Kaboré, Thierry Léfèvre, Philippe Guerin, Halidou Tinto Enhanced effect of seasonal malaria chemoprevention when coupled with nutrients supplementation for preventing malaria in children under 5 years old in Burkina Faso: a randomized open label trial Journal Article In: Malaria journal, vol. 22, iss. 1, 2023, ISSN: 1475-2875. Abstract | BibTeX | Tags: Antimalarials* / therapeutic use, Bérenger Kaboré, Burkina Faso / epidemiology, Chemoprevention, Child, Cross-Sectional Studies, Dietary Supplements, doi:10.1186/s12936-023-04745-6, Halidou Tinto, Humans, Infant, Malaria* / epidemiology, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, Nutrients, Paul Sondo, PMC10585892, pmid:37853408, Preschool, PubMed Abstract, Randomized controlled trial, Seasons, Vitamin A / therapeutic use | Links: @article{Sondo2023, Background: In rural African settings, most of the children under the coverage of Seasonal Malaria Chemoprevention (SMC) are also undernourished at the time of SMC delivery, justifying the need for packaging malarial and nutritional interventions. This study aimed at assessing the impact of SMC by coupling the intervention with nutrients supplementation for preventing malaria in children less than 5 years old in Burkina Faso. Methods: A randomized trial was carried out between July 2020 and June 2021 in the health district of Nanoro, Burkina Faso. Children (n = 1059) under SMC coverage were randomly assigned to one of the three study arms SMC + Vitamin A (SMC-A | |||
Arnold Fottsoh Fokam, Toussaint Rouamba, Sekou Samadoulougou, Yazoume Ye, Fati Kirakoya-Samadoulougou A Bayesian spatio-temporal framework to assess the effect of seasonal malaria chemoprevention on children under 5 years in Cameroon from 2016 to 2021 using routine data Journal Article In: Malaria journal, vol. 22, iss. 1, 2023, ISSN: 1475-2875. Abstract | BibTeX | Tags: Antimalarials* / therapeutic use, Arnold Fottsoh Fokam, Bayes Theorem, Cameroon / epidemiology, Chemoprevention, Child, doi:10.1186/s12936-023-04677-1, Fati Kirakoya-Samadoulougou, Humans, Infant, Malaria* / drug therapy, Malaria* / epidemiology, Malaria* / prevention & control, MEDLINE, National Center for Biotechnology Information, National Institutes of Health, National Library of Medicine, NCBI, NIH, NLM, PMC10640753, pmid:37951942, Preschool, PubMed Abstract, Seasons, Toussaint Rouamba | Links: @article{nokey, Background: Malaria affects millions of Cameroonian children under 5 years of age living in the North and Far North regions. These regions bear the greatest burden, particularly for children under 5 years of age. To reduce the burden of disease in these regions, Cameroon adopted the Seasonal Malaria Chemoprevention (SMC) in 2016 and has implemented it each year since its adoption. However, no previous studies have systematically assessed the effects of this intervention in Cameroon. It is important to understand its effect and whether its implementation could be improved. This study aimed to assess the effect of SMC in Cameroon during the period 2016–2021 on malaria morbidity in children under 5 years of age using routine data. Methods: Data on malaria cases were extracted from the Cameroon Health Monitoring Information System (HMIS) from January 1, 2011, to December 31, 2021. Health facilities report these data monthly on a single platform, the District Health Information System version 2 (DHIS2). Thus, a controlled interrupted time-series model in a Bayesian framework was used to evaluate the effects of the SMC on malaria morbidity. Results: SMC implementation was associated with a reduction in the incidence of uncomplicated malaria cases during the high-transmission periods from 2016 to 2021. Regarding the incidence of severe malaria during the high-transmission period, a reduction was found over the period 2016–2019. The highest reduction was registered during the second year of implementation in 2017:15% (95% Credible Interval, 10–19) of uncomplicated malaria cases and 51% (47–54) of confirmed severe malaria cases. Conclusion: The addition of SMC to the malaria intervention package in Cameroon decreased the incidence of uncomplicated and severe malaria among children under 5 years of age. Based on these findings, this study supports the wide implementation of SMC to reduce the malaria burden in Cameroon as well as the use of routine malaria data to monitor the efficiency of the strategy in a timely manner. | |||
2022 |
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![]() | Paul Sondo, Marc Christian Tahita, Hamidou Ilboudo, Toussaint Rouamba, Karim Derra, Gauthier Tougri, Florence Ouédraogo, Béatrice Marie Adélaïde Konseibo, Eli Roamba, Sabina Dahlström Otienoburu, Bérenger Kaboré, Kalynn Kennon, Kadija Ouédraogo, Wend-Timbe-Noma Arlette Raïssa Zongo, Fadima Yaya Bocoum, Kasia Stepniewska, Mehul Dhorda, Philippe J. Guérin, Halidou Tinto Boosting the impact of seasonal malaria chemoprevention (SMC) through simultaneous screening and treatment of household members of children receiving SMC in Burkina Faso: a protocol for a randomized open label trial Journal Article In: Archives of Public Health, vol. 80, iss. 1, pp. 41, 2022, ISSN: 2049-3258. Abstract | BibTeX | Tags: Africa, Amodiaquine, Burkina Faso, Chemoprevention, Dihydro artemisinin Piperaquine, Malaria, Plasmodium falciparum, Sulfadoxine-pyrimethamine | Links: @article{Sondo2022, BACKGROUND Plasmodium falciparum malaria remains a major public health concern in sub-Sahara Africa. Seasonal malaria chemoprevention (SMC) with amodiaquine + sulfadoxine-pyrimethamine is one of the most important preventive interventions. Despite its implementation, the burden of malaria is still very high in children under five years old in Burkina Faso, suggesting that the expected impact of this promising strategy might not be attained. Development of innovative strategies to improve the efficacy of these existing malaria control measures is essential. In such context, we postulate that screening and treatment of malaria in household members of children receiving SMC could greatly improve the impact of SMC intervention and reduce malaria transmission in endemic settings. METHODS This randomized superiority trial will be carried out in the Nanoro health district, Burkina Faso. The unit of randomisation will be the household and all eligible children from a household will be allocated to the same study group. Households with 3-59 months old children will be assigned to either (i) control group (SMC alone) or (ii) intervention (SMC+ screening of household members with standard Histidin Rich Protein Rapid Diagnostic Test (HRP2-RDT) and treatment if positive). The sample size will be 526 isolated households per arm, i.e., around 1052 children under SMC coverage and an expected 1315 household members. Included children will be followed-up for 24 months to fully cover two consecutive malaria transmission seasons and two SMC cycles. Children will be actively followed-up during the malaria transmission seasons while in the dry seasons the follow-up will be passive. CONCLUSION The study will respond to a major public health concern by providing evidence of the efficacy of an innovative strategy to boost the impact of SMC intervention. | ||
2021 |
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![]() | Mphatso Dennis Phiri, Matthew Cairns, Issaka Zongo, Frederic Nikiema, Modibo Diarra, Rakiswendé Serge Yerbanga, Amadou Barry, Amadou Tapily, Samba Coumare, Ismaila Thera, Irene Kuepfer, Paul Milligan, Halidou Tinto, Alassane Dicko, Jean Bosco Ouédraogo, Brian Greenwood, Daniel Chandramohan, Issaka Sagara 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 houndé, Burkina Faso, and bougouni, Mali Journal Article In: Clin. Infect. Dis., vol. 73, no. 7, pp. e2379–e2386, 2021, ISSN: 1537-6591 1058-4838, (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. PMID: 33417683 PMCID: PMC8492219). Abstract | BibTeX | Tags: 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 | Links: @article{Phiri2021-oy, 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. | ||
![]() | Daniel Chandramohan, Issaka Zongo, Issaka Sagara, Matthew Cairns, Rakiswendé-Serge Yerbanga, Modibo Diarra, Frédéric Niki`ema, Amadou Tapily, Frédéric Sompougdou, Djibrilla Issiaka, Charles Zoungrana, Koualy Sanogo, Alassane Haro, Mahamadou Kaya, Abdoul-Aziz Sienou, Seydou Traore, Almahamoudou Mahamar, Ismaila Thera, Kalifa Diarra, Amagana Dolo, Irene Kuepfer, Paul Snell, Paul Milligan, Christian Ockenhouse, Opokua Ofori-Anyinam, Halidou Tinto, Abdoulaye Djimde, Jean-Bosco Ouédraogo, Alassane Dicko, Brian Greenwood Seasonal malaria vaccination with or without seasonal malaria chemoprevention Journal Article In: N. Engl. J. Med., vol. 385, no. 11, pp. 1005–1017, 2021, ISSN: 1533-4406 0028-4793, (Copyright © 2021 Massachusetts Medical Society. Place: United States PMID: 34432975). Abstract | BibTeX | Tags: Amodiaquine/therapeutic use, Antimalarials/adverse effects/therapeutic use, Burkina Faso/epidemiology, Chemoprevention, Combination, Combined Modality Therapy, Double-Blind Method, Drug Combinations, Drug Therapy, Falciparum/epidemiology/mortality/prevention & control, Febrile/etiology, Female, Hospitalization/statistics & numerical data, Humans, Infant, Malaria, Malaria Vaccines/administration & dosage/adverse effects, Male, Mali/epidemiology, Pyrimethamine/therapeutic use, Seasons, Seizures, Sulfadoxine/therapeutic use | Links: @article{Chandramohan2021-qm, BACKGROUND: Malaria control remains a challenge in many parts of the Sahel and sub-Sahel regions of Africa. METHODS: We conducted an individually randomized, controlled trial to assess whether seasonal vaccination with RTS,S/AS01E was noninferior to chemoprevention in preventing uncomplicated malaria and whether the two interventions combined were superior to either one alone in preventing uncomplicated malaria and severe malaria-related outcomes. RESULTS: We randomly assigned 6861 children 5 to 17 months of age to receive sulfadoxine-pyrimethamine and amodiaquine (2287 children [chemoprevention-alone group]), RTS,S/AS01E (2288 children [vaccine-alone group]), or chemoprevention and RTS,S/AS01E (2286 children [combination group]). Of these, 1965, 1988, and 1967 children in the three groups, respectively, received the first dose of the assigned intervention and were followed for 3 years. Febrile seizure developed in 5 children the day after receipt of the vaccine, but the children recovered and had no sequelae. There were 305 events of uncomplicated clinical malaria per 1000 person-years at risk in the chemoprevention-alone group, 278 events per 1000 person-years in the vaccine-alone group, and 113 events per 1000 person-years in the combination group. The hazard ratio for the protective efficacy of RTS,S/AS01E as compared with chemoprevention was 0.92 (95% confidence interval [CI], 0.84 to 1.01), which excluded the prespecified noninferiority margin of 1.20. The protective efficacy of the combination as compared with chemoprevention alone was 62.8% (95% CI, 58.4 to 66.8) against clinical malaria, 70.5% (95% CI, 41.9 to 85.0) against hospital admission with severe malaria according to the World Health Organization definition, and 72.9% (95% CI, 2.9 to 92.4) against death from malaria. The protective efficacy of the combination as compared with the vaccine alone against these outcomes was 59.6% (95% CI, 54.7 to 64.0), 70.6% (95% CI, 42.3 to 85.0), and 75.3% (95% CI, 12.5 to 93.0), respectively. CONCLUSIONS: Administration of RTS,S/AS01E was noninferior to chemoprevention in preventing uncomplicated malaria. The combination of these interventions resulted in a substantially lower incidence of uncomplicated malaria, severe malaria, and death from malaria than either intervention alone. (Funded by the Joint Global Health Trials and PATH; ClinicalTrials.gov number, NCT03143218.). | ||
![]() | Koudraogo Bienvenue Yaméogo, Rakiswendé Serge Yerbanga, Seydou Bienvenu Ouattara, Franck A Yao, Thierry Lef`evre, Issaka Zongo, Frederic Niki`ema, Yves Daniel Compaoré, Halidou Tinto, Daniel Chandramohan, Brian Greenwood, Adrien M G Belem, Anna Cohuet, Jean Bosco Ouédraogo Effect of seasonal malaria chemoprevention plus azithromycin on Plasmodium falciparum transmission: gametocyte infectivity and mosquito fitness Journal Article In: Malar. J., vol. 20, no. 1, pp. 326, 2021, ISSN: 1475-2875, (© 2021. The Author(s). PMID: 34315475 PMCID: PMC8314489). Abstract | BibTeX | Tags: Amodiaquine/administration & dosage, Animals, Antimalarials/administration & dosage, Chemoprevention, Child, Culicidae/physiology, Drug Combinations, Falciparum/prevention & control/transmission, Gametocytes, Genetic Fitness, Humans, Malaria, Plasmodium falciparum/physiology, Preschool, Pyrimethamine/administration & dosage, seasonal malaria chemoprevention, Seasons, Sulfadoxine/administration & dosage, Transmission | Links: @article{Yameogo2021-bb, BACKGROUND: Seasonal malaria chemoprevention (SMC) consists of administration of sulfadoxine-pyrimethamine (SP) + amodiaquine (AQ) at monthly intervals to children during the malaria transmission period. Whether the addition of azithromycin (AZ) to SMC could potentiate the benefit of the intervention was tested through a double-blind, randomized, placebo-controlled trial. The effect of SMC and the addition of AZ, on malaria transmission and on the life history traits of Anopheles gambiae mosquitoes have been investigated. METHODS: The study included 438 children randomly selected from among participants in the SMC + AZ trial and 198 children from the same area who did not receive chemoprevention. For each participant in the SMC + AZ trial, blood was collected 14 to 21 days post treatment, examined for the presence of malaria sexual and asexual stages and provided as a blood meal to An. gambiae females using a direct membrane-feeding assay. RESULTS: The SMC treatment, with or without AZ, significantly reduced the prevalence of asexual Plasmodium falciparum (LRT X(2)(2) = 69, P < 0.0001) and the gametocyte prevalence (LRT X(2)(2) = 54, P < 0.0001). In addition, the proportion of infectious feeds (LRT X(2)(2) = 61, P < 0.0001) and the prevalence of oocysts among exposed mosquitoes (LRT X(2)(2) = 22.8, P < 0.001) was reduced when mosquitoes were fed on blood from treated children compared to untreated controls. The addition of AZ to SPAQ was associated with an increased proportion of infectious feeds (LRT X(2)(1) = 5.2, P = 0.02), suggesting a significant effect of AZ on gametocyte infectivity. There was a slight negative effect of SPAQ and SPAQ + AZ on mosquito survival compared to mosquitoes fed with blood from control children (LRTX(2)(2) = 330, P < 0.0001). CONCLUSION: This study demonstrates that SMC may contribute to a reduction in human to mosquito transmission of P. falciparum, and the reduced mosquito longevity observed for females fed on treated blood may increase the benefit of this intervention in control of malaria. The addition of AZ to SPAQ in SMC appeared to enhance the infectivity of gametocytes providing further evidence that this combination is not an appropriate intervention. | ||
![]() | Paul Sondo, Marc Christian Tahita, Toussaint Rouamba, Karim Derra, Bérenger Kaboré, Cheick Sa"id Compaoré, Florence Ouédraogo, Eli Rouamba, Hamidou Ilboudo, Estelle A"issa Bambara, Macaire Nana, Edmond Yabré Sawadogo, Hermann Sorgho, Athanase Mwinessobaonfou Somé, Innocent Valéa, Prabin Dahal, Maminata Traoré/Coulibaly, Halidou Tinto Assessment of a combined strategy of seasonal malaria chemoprevention and supplementation with vitamin A, zinc and Plumpy'Doz™ to prevent malaria and malnutrition in children under 5 years old in Burkina Faso: a randomized open-label trial (SMC-NUT) Journal Article In: Trials, vol. 22, no. 1, pp. 360, 2021, ISSN: 1745-6215, (PMID: 34030705 PMCID: PMC8142067). Abstract | BibTeX | Tags: Antimalarials/adverse effects, Burkina Faso/epidemiology, Chemoprevention, Child, Child Nutrition Disorders, Dietary Supplements, Humans, Infant, Malaria, Malaria/diagnosis/epidemiology/prevention & control, Malnutrition, Malnutrition/diagnosis/drug therapy/prevention & control, Pharmaceutical Preparations, Plumpy’Doz™, Preschool, Randomized controlled trial, Seasonal chemoprevention, Seasons, Vitamin A, Vitamin A/adverse effects, Zinc | Links: @article{Sondo2021-kc, BACKGROUND: Malaria and malnutrition represent major public health concerns worldwide especially in Sub-Sahara Africa. Despite implementation of seasonal malaria chemoprophylaxis (SMC), an intervention aimed at reducing malaria incidence among children aged 3-59 months, the burden of malaria and associated mortality among children below age 5 years remains high in Burkina Faso. Malnutrition, in particular micronutrient deficiency, appears to be one of the potential factors that can negatively affect the effectiveness of SMC. Treating micronutrient deficiencies is known to reduce the incidence of malaria in highly prevalent malaria zone such as rural settings. Therefore, we hypothesized that a combined strategy of SMC together with a daily oral nutrients supplement will enhance the immune response and decrease the incidence of malaria and malnutrition among children under SMC coverage. METHODS: Children (6-59 months) under SMC coverage receiving vitamin A supplementation will be randomly assigned to one of the three study arms (a) SMC + vitamin A alone, (b) SMC + vitamin A + zinc, or (c) SMC + vitamin A + Plumpy'Doz™ using 1:1:1 allocation ratio. After each SMC monthly distribution, children will be visited at home to confirm drug administration and followed-up for 1 year. Anthropometric indicators will be recorded at each visit and blood samples will be collected for microscopy slides, haemoglobin measurement, and spotted onto filter paper for further PCR analyses. The primary outcome measure is the incidence of malaria in each arm. Secondary outcome measures will include mid-upper arm circumference and weight gain from baseline measurements, coverage and compliance to SMC, occurrence of adverse events (AEs), and prevalence of molecular markers of antimalarial resistance comprising Pfcrt, Pfmdr1, Pfdhfr, and Pfdhps. DISCUSSION: This study will demonstrate an integrated strategy of malaria and malnutrition programmes in order to mutualize resources for best impact. By relying on existing strategies, the policy implementation of this joint intervention will be scalable at country and regional levels. TRIAL REGISTRATION: ClinicalTrials.gov NCT04238845 . Registered on 23 January 2020 https://clinicaltrials.gov/ct2/show/NCT04238845. | ||
2020 |
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![]() | André Lin Ouédraogo, Julie Zhang, Halidou Tinto, Innocent Valéa, Edward A Wenger A microplanning model to improve door-to-door health service delivery: the case of Seasonal Malaria Chemoprevention in Sub-Saharan African villages Journal Article In: BMC Health Serv. Res., vol. 20, no. 1, pp. 1128, 2020, ISSN: 1472-6963, (PMID: 33287825 PMCID: PMC7720067). Abstract | BibTeX | Tags: 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 | Links: @article{Ouedraogo2020-vc, 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. |
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