Impact of seasonal malaria chemoprevention on prevalence of malaria infection in malaria indicator surveys in Burkina Faso and Nigeria.

Autor: de Cola MA; Department of Infectious Disease Epidemiology, Imperial College, London, UK m.de-cola20@imperial.ac.uk.; Malaria Consortium, London, UK., Sawadogo B; Malaria Consortium, Ouagadougou, Burkina Faso., Richardson S; Vanke School of Public Health, Tsinghua University, Beijing, China., Ibinaiye T; Malaria Consortium, Abuja, Nigeria., Traoré A; Malaria Consortium, Ougadougou, Burkina Faso., Compaoré CS; Malaria Consortium, Ouagadougou, Burkina Faso., Oguoma C; Malaria Consortium, Abuja, Nigeria., Oresanya O; Malaria Consortium, Abuja, Nigeria., Tougri G; Ministry of Health, Ouagadougou, Burkina Faso., Rassi C; Malaria Consortium, London, UK., Roca-Feltrer A; Malaria Consortium, London, UK., Walker P; Department of Infectious Disease Epidemiology, Imperial College, London, UK., Okell LC; Department of Infectious Disease Epidemiology, Imperial College, London, UK.
Jazyk: angličtina
Zdroj: BMJ global health [BMJ Glob Health] 2022 May; Vol. 7 (5).
DOI: 10.1136/bmjgh-2021-008021
Abstrakt: Background: In 2012, the WHO issued a policy recommendation for the use of seasonal malaria chemoprevention (SMC) to children 3-59 months in areas of highly seasonal malaria transmission. Clinical trials have found SMC to prevent around 75% of clinical malaria. Impact under routine programmatic conditions has been assessed during research studies but there is a need to identify sustainable methods to monitor impact using routinely collected data.
Methods: Data from Demographic Health Surveys were merged with rainfall, geographical and programme data in Burkina Faso (2010, 2014, 2017) and Nigeria (2010, 2015, 2018) to assess impact of SMC. We conducted mixed-effects logistic regression to predict presence of malaria infection in children aged 6-59 months (rapid diagnostic test (RDT) and microscopy, separately).
Results: We found strong evidence that SMC administration decreases odds of malaria measured by RDT during SMC programmes, after controlling for seasonal factors, age, sex, net use and other variables (Burkina Faso OR 0.28, 95% CI 0.21 to 0.37, p<0.001; Nigeria OR 0.40, 95% CI 0.30 to 0.55, p<0.001). The odds of malaria were lower up to 2 months post-SMC in Burkina Faso (1-month post-SMC: OR 0.29, 95% CI 0.12 to 0.72, p=0.01; 2 months post-SMC: OR: 0.33, 95% CI 0.17 to 0.64, p<0.001). The odds of malaria were lower up to 1 month post-SMC in Nigeria but was not statistically significant (1-month post-SMC 0.49, 95% CI 0.23 to 1.05, p=0.07). A similar but weaker effect was seen for microscopy (Burkina Faso OR 0.38, 95% CI 0.29 to 0.52, p<0.001; Nigeria OR 0.53, 95% CI 0.38 to 0.76, p<0.001).
Conclusions: Impact of SMC can be detected in reduced prevalence of malaria from data collected through household surveys if conducted during SMC administration or within 2 months afterwards. Such evidence could contribute to broader evaluation of impact of SMC programmes.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze: MEDLINE