Dihydroartemisinin-Piperaquine Chemoprevention and Malaria Incidence After Severe Flooding: Evaluation of a Pragmatic Intervention in Rural Uganda
| Autor: | Brandon D Hollingsworth, Ross M. Boyce, Jonathan J. Juliano, Edgar Mulogo, Mark J. Siedner, Emma Baguma, Raquel Reyes, Moses Ntaro, Erin Xu, Amanda Brown-Marusiak, Varun Goel, Sarah G. Staedke, Rabbison Muhindo |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Adult Chemoprevention Piperazines Antimalarials Dihydroartemisinin/piperaquine Intervention (counseling) parasitic diseases medicine Humans Uganda Mass drug administration Child Disease burden Rapid diagnostic test business.industry Incidence (epidemiology) Incidence Flooding (psychology) medicine.disease Artemisinins Floods Malaria Major Articles and Commentaries Infectious Diseases Quinolines business Demography |
| Zdroj: | Clin Infect Dis |
| ISSN: | 1058-4838 |
| Popis: | Background Malaria epidemics are a well-described phenomenon after extreme precipitation and flooding. Yet, few studies have examined mitigation measures to prevent post-flood malaria epidemics. Methods We evaluated a malaria chemoprevention program implemented in response to severe flooding in western Uganda. Children aged ≤12 years from 1 village were eligible to receive 3 monthly rounds of dihydroartemisinin-piperaquine (DP). Two neighboring villages served as controls. Malaria cases were defined as individuals with a positive rapid diagnostic test result as recorded in health center registers. We performed a difference-in-differences analysis to estimate changes in the incidence and test positivity of malaria between intervention and control villages. Results A total of 554 children received at least 1 round of chemoprevention, with 75% participating in at least 2 rounds. Compared with control villages, we estimated a 53.4% reduction (adjusted rate ratio [aRR], 0.47; 95% confidence interval [CI]: .34–.62; P Conclusions Three rounds of chemoprevention with DP delivered under pragmatic conditions reduced the incidence of malaria after severe flooding in western Uganda. These findings provide a proof-of-concept for the use of malaria chemoprevention to reduce excess disease burden associated with severe flooding. |
| Databáze: | OpenAIRE |
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