1. Two-Year Scale-Up of Seasonal Malaria Chemoprevention Reduced Malaria Morbidity among Children in the Health District of Koutiala, Mali
- Author
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Moussa Djimde, Ogobara K. Doumbo, Amadou Bamadio, Boubou Sangare, Abdoulaye Djimde, Estrella Lasry, Alassane Dicko, Jean Gaudart, Hamma Maiga, Samba Coumare, Djibril Traore, Issaka Sagara, Aly Tembely, Yeyia Dicko, Modibo Diarra, Institut National de Recherche en Santé Publique [Bamako] (INRSP), Malaria Research and Training Center [Bamako, Mali], Université de Bamako, Université des Sciences, des Techniques et des Technologies de Bamako (USTTB), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Biostatistique et technologies de l'information et de la communication (BioSTIC) - [Hôpital de la Timone - APHM] (BiosTIC ), Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Médecins Sans Frontières - Doctors Without Borders [New York] (MSF-USA), Université des sciences, des techniques et des technologies de Bamako (USTTB), Service Biostatistique et Technologies de l’Information et de la Communication [AP-HM Hôpital de la Timone] (BioSTIC), Hôpital de la Timone [CHU - APHM] (TIMONE), and Dupuis, Christine
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MESH: Chemoprevention ,Health, Toxicology and Mutagenesis ,[SDV]Life Sciences [q-bio] ,lcsh:Medicine ,morbidity ,Controlled studies ,Mali ,0302 clinical medicine ,MESH: Child ,Child ,0303 health sciences ,musculoskeletal system ,MESH: Infant ,3. Good health ,seasonal malaria chemoprevention ,[SDV] Life Sciences [q-bio] ,Drug Combinations ,Pyrimethamine ,Child, Preschool ,cardiovascular system ,Female ,Seasons ,medicine.drug ,medicine.medical_specialty ,Anemia ,MESH: Pyrimethamine ,030231 tropical medicine ,MESH: Malaria ,malaria ,Malaria morbidity ,Amodiaquine ,Chemoprevention ,Article ,Antimalarials ,03 medical and health sciences ,MESH: Cross-Sectional Studies ,Internal medicine ,Sulfadoxine ,parasitic diseases ,medicine ,Humans ,MESH: Drug Combinations ,MESH: Humans ,030306 microbiology ,business.industry ,lcsh:R ,MESH: Child, Preschool ,Public Health, Environmental and Occupational Health ,Infant ,MESH: Mali ,medicine.disease ,MESH: Antimalarials ,Cross-Sectional Studies ,MESH: Morbidity ,Propensity score matching ,business ,MESH: Female ,MESH: Seasons ,Malaria ,MESH: Sulfadoxine - Abstract
Background: Previous controlled studies demonstrated seasonal malaria chemoprevention (SMC) reduces malaria morbidity by >, 80% in children aged 3&ndash, 59 months. Here, we assessed malaria morbidity after large-scale SMC implementation during a pilot campaign in the health district of Koutiala, Mali. Methods: Starting in August 2012, children received three rounds of SMC with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ). From July 2013 onward, children received four rounds of SMC. Prevalence of malaria infection, clinical malaria and anemia were assessed during two cross-sectional surveys conducted in August 2012 and June 2014. Investigations involved 20 randomly selected clusters in 2012 against 10 clusters in 2014. Results: Overall, 662 children were included in 2012, and 670 in 2014. Children in 2014 versus those surveyed in 2012 showed reduced proportions of malaria infection (12.4% in 2014 versus 28.7% in 2012 (p = 0.001)), clinical malaria (0.3% versus 4.2%, respectively (p <, 0.001)), and anemia (50.1% versus 67.4%, respectively (p = 0.001)). A propensity score approach that accounts for environmental differences showed that SMC conveyed a significant protective effect against malaria infection (IR = 0.01, 95% CI (0.0001, 0.09), clinical malaria (OR = 0.25, 95% CI (0.06, 0.85)), and hemoglobin concentration (&beta, = 1.3, 95% CI (0.69, 1.96)) in 2012 and 2014, respectively. Conclusion: SMC significantly reduced frequency of malaria infection, clinical malaria and anemia two years after SMC scale-up in Koutiala.
- Published
- 2020