Projected health impact of post-discharge malaria chemoprevention among children with severe malarial anaemia in Africa.

Autor: Okell LC; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, W2 1PG, UK. l.okell@imperial.ac.uk., Kwambai TK; Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.; Department of Clinical Sciences, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK., Dhabangi A; College of Health Sciences, Makerere University, Kampala, Uganda., Khairallah C; Department of Clinical Sciences, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK., Nkosi-Gondwe T; Kamuzu University of Health Sciences, Blantyre, Malawi.; Training and Research Unit of Excellence, Blantyre, Malawi., Winskill P; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, W2 1PG, UK., Opoka R; College of Health Sciences, Makerere University, Kampala, Uganda., Mousa A; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, W2 1PG, UK., Kühl MJ; Section for Ethics and Health Economics, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway., Lucas TCD; Big Data Institute, University of Oxford, Oxford, UK., Challenger JD; MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, W2 1PG, UK., Idro R; College of Health Sciences, Makerere University, Kampala, Uganda., Weiss DJ; Malaria Atlas Project, Telethon Kids Institute, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, Australia.; Curtin University, Bentley, Australia., Cairns M; International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK., Ter Kuile FO; Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.; Department of Clinical Sciences, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK., Phiri K; Kamuzu University of Health Sciences, Blantyre, Malawi.; Training and Research Unit of Excellence, Blantyre, Malawi., Robberstad B; Section for Ethics and Health Economics, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway., Mori AT; Section for Ethics and Health Economics, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway. pax_amani@yahoo.com.; Chr. Michelsen Institute, P.O. Box 6033, N-5892, Bergen, Norway. pax_amani@yahoo.com.; Muhimbili University of Health and Allied Sciences, P.O.Box 65001, Dar es Salaam, Tanzania. pax_amani@yahoo.com.
Jazyk: angličtina
Zdroj: Nature communications [Nat Commun] 2023 Jan 25; Vol. 14 (1), pp. 402. Date of Electronic Publication: 2023 Jan 25.
DOI: 10.1038/s41467-023-35939-w
Abstrakt: Children recovering from severe malarial anaemia (SMA) remain at high risk of readmission and death after discharge from hospital. However, a recent trial found that post-discharge malaria chemoprevention (PDMC) with dihydroartemisinin-piperaquine reduces this risk. We developed a mathematical model describing the daily incidence of uncomplicated and severe malaria requiring readmission among 0-5-year old children after hospitalised SMA. We fitted the model to a multicentre clinical PDMC trial using Bayesian methods and modelled the potential impact of PDMC across malaria-endemic African countries. In the 20 highest-burden countries, we estimate that only 2-5 children need to be given PDMC to prevent one hospitalised malaria episode, and less than 100 to prevent one death. If all hospitalised SMA cases access PDMC in moderate-to-high transmission areas, 38,600 (range 16,900-88,400) malaria-associated readmissions could be prevented annually, depending on access to hospital care. We estimate that recurrent SMA post-discharge constitutes 19% of all SMA episodes in moderate-to-high transmission settings.
(© 2023. The Author(s).)
Databáze: MEDLINE
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