Effect of a fifth round of seasonal malaria chemoprevention in children aged 5–14 years in Dangassa, an area of long transmission in Mali

IF 2 Q3 INFECTIOUS DISEASES Parasite Epidemiology and Control Pub Date : 2023-02-01 DOI:10.1016/j.parepi.2022.e00283

Drissa Konate , Sory I. Diawara , Nafomon Sogoba , Jeffrey G. Shaffer , Bourama Keita , Abdourhamane Cisse , Ibrahim Sanogo , Ilo Dicko , Merepen dite Agnes Guindo , Saidou Balam , Abdouramane Traore , Salimata Kante , Assitan Dembele , Fatoumata Kasse , Larissa Denou , Seidina A.S. Diakite , Karim Traore , Sidibe M'Baye Thiam , Vincent Sanogo , Mahamoudou Toure , Mahamadou Diakite

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引用次数: 2

Abstract

Despite a significant reduction in the burden of malaria in children under five years-old, the efficient implementation of seasonal malaria chemoprevention (SMC) at large scale remains a major concern in areas with long malaria transmission. Low coverage rate in the unattainable areas during the rainy season, a shift in the risk of malaria to older children and the rebound in malaria incidence after stopping drug administration are mainly reported in these areas. These gaps represent a major challenge in the efficient implementation of SMC measures. An open randomized study was conducted to assess the effect of a fifth additional round to current regime of SMC in older children living in Dangassa, a rural malaria endemic area. Poisson regression Model was used to estimate the reduction in malaria incidence in the intervention group compared to the control group including age groups (5–9 and 10–14 years) and the use of long-lasting insecticidal nets (LLINs; Yes or No) with a threshold at 5%. Overall, a downward trend in participation rate was observed from August (94.3%) to November (87.2%). In November (round 4), the risk of malaria incidence was similar in both groups (IRR = 0.66, 95%CI [0.35–1.22]). In December (round 5), a decrease of 51% in malaria incidence was observed in intervention group compared to control group adjusted for age groups and the use of LLINs (IRR = 0.49, 95%CI [0.26–0.94]), of which 17% of reduction is attributable to the 5th round in the intervention group. An additional fifth round of SMC resulted in a significant reduction of malaria incidence in the intervention group. The number of SMC rounds could be adapted to the local condition of malaria transmission.

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马里长期传播地区丹加萨5-14岁儿童第五轮季节性疟疾化学预防的效果

尽管五岁以下儿童的疟疾负担显著减轻，但在疟疾长期传播地区，大规模有效实施季节性疟疾化学预防仍然是一个主要问题。据报道，雨季无法到达的地区覆盖率低，疟疾风险向年龄较大的儿童转移，以及停止用药后疟疾发病率回升，主要发生在这些地区。这些差距是有效执行方案管理委员会措施的一大挑战。进行了一项开放的随机研究，以评估对居住在农村疟疾流行地区丹加萨的大龄儿童进行第五轮补充SMC治疗的效果。泊松回归模型用于估计干预组与对照组相比疟疾发病率的降低，包括年龄组（5-9岁和10-14岁）和使用长效驱虫蚊帐（LLIN；是或否），阈值为5%。总体而言，从8月（94.3%）到11月（87.2%），参与率呈下降趋势。在11月（第4轮），两组的疟疾发病风险相似（IRR=0.66，95%CI[0.35-1.22]）。在12月（第5轮），与对照组相比，经年龄组和LLIN使用调整后，干预组的疟疾发病率下降了51%（IRR=0.49，95%CI[0.26-0.94]），其中17%的下降归因于干预组的第5轮。额外的第五轮SMC使干预组的疟疾发病率显著降低。SMC查房的数量可以根据疟疾传播的当地情况进行调整。

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来源期刊

Parasite Epidemiology and Control Medicine-Infectious Diseases

CiteScore

5.70

自引率

3.10%

发文量

审稿时长

17 weeks

期刊介绍： Parasite Epidemiology and Control is an Open Access journal. There is an increasing amount of research in the parasitology area that analyses the patterns, causes, and effects of health and disease conditions in defined populations. This epidemiology of parasite infectious diseases is predominantly studied in human populations but also spans other major hosts of parasitic infections and as such this journal will have a broad remit. We will focus on the major areas of epidemiological study including disease etiology, disease surveillance, drug resistance and geographical spread and screening, biomonitoring, and comparisons of treatment effects in clinical trials for both human and other animals. We will also look at the epidemiology and control of vector insects. The journal will also cover the use of geographic information systems (Epi-GIS) for epidemiological surveillance which is a rapidly growing area of research in infectious diseases. Molecular epidemiological approaches are also particularly encouraged.