Effectiveness and safety of intermittent preventive treatment for malaria using either dihydroartemisinin-piperaquine or artesunate-amodiaquine in reducing malaria related morbidities and improving cognitive ability in school-aged children in Tanzania: A study protocol for a controlled randomised trial

Makenga, Geofrey; Baraka, Vito; Francis, Filbert; Nakato, Swabra; Gesase, Samwel; Mtove, George; Madebe, Rashid; Kyaruzi, Edna; Minja, Daniel T. R.; Lusingu, John; Geertruyden, Jean-Pierre Van

doi:10.1016/j.conctc.2020.100546

Cited by 11 publications

(21 citation statements)

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“…This study was a comprehensive baseline survey, within the scope of a randomised, controlled trial enrolling asymptomatic schoolchildren and investigating the effectiveness and safety of two antimalarial drugs namely Dihydroartemisinin-piperaquine (DP) and Artesunate-amodiaquine (ASAQ) in preventing malaria related morbidity in schoolchildren living in high endemic areas. The trial design and method of the intervention have previously been detailed in the study protocol [ 29 ] (also registered on clinical trials.gov -NCT03640403). A comprehensive survey was conducted from Feb 25 th to April 29 th 2019, covering eligible schoolchildren and their respective households.…”

Section: Methodsmentioning

confidence: 99%

“…haematobium . Technical aspects of blood testing and other assessment are detailed on the study protocol [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

“…The study participants for ease of identification wore coloured, light scarfs. As described in the study protocol [ 29 ] during this test, children ran continuously between two lines apart turning when signalled to do so by recorded beeps and a “shuttle” was defined as a run between one line to another. Each fitness score was then translated into VO2max (mL kg−1 min−1) by calculation using a formula by Leger et al ,1988 [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

“…The sample size was estimated on the basis of the intervention described in the main study [ 29 ], where a sample of 1602 schoolchildren was expected. During the surveys, data were entered directly into the REDCap platforms using mobile REDCap tools [ 29 , 30 , 41 ].…”

Section: Methodsmentioning

confidence: 99%

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Attributable risk factors for asymptomatic malaria and anaemia and their association with cognitive and psychomotor functions in schoolchildren of north-eastern Tanzania

et al. 2022

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In Africa, children aged 5 to 15 years (school age) comprises more than 50% (>339 million) of the under 19 years population, and are highly burdened by malaria and anaemia that impair cognitive development. For the prospects of improving health in African citizens, understanding malaria and its relation to anaemia in school-aged children, it is crucial to inform targeted interventions for malaria control and accelerate elimination efforts as part of improved school health policy. We conducted a study to determine the risk factors for asymptomatic malaria and their association to anaemia. We explored the prevalence of antimalarial drug resistance as well as the association of asymptomatic malaria infection and anaemia on cognitive and psychomotor functions in school-aged children living in high endemic areas. This study was a comprehensive baseline survey, within the scope of a randomised, controlled trial on the effectiveness and safety of antimalarial drugs in preventing malaria and its related morbidity in schoolchildren. We enrolled 1,587 schoolchildren from 7 primary schools located in Muheza, north-eastern Tanzania. Finger-pricked blood samples were collected for estimation of malaria parasitaemia using a microscope, haemoglobin concentration using a haemoglobinometer, and markers of drug resistance processed from dried blood spots (DBS). Psychomotor and Cognitive functions were assessed using a ‘20 metre Shuttle run’ and a test of everyday attention for children (TEA-Ch), respectively. The prevalence of asymptomatic malaria parasitaemia, anaemia and stunting was 26.4%, 49.8%, and 21.0%, respectively with marked variation across schools. In multivariate models, asymptomatic malaria parasitaemia attributed to 61% of anaemia with a respective population attribution fraction of 16%. Stunting, not sleeping under a bednet and illiterate parent or guardian were other factors attributing to 7%, 9%, and 5% of anaemia in the study population, respectively. Factors such as age group (10–15 years), not sleeping under a bednet, low socioeconomic status, parents’ or guardians’ with a low level of education, children overcrowding in a household, and fewer rooms in a household were significantly attributed to higher malaria infection. There was no significant association between malaria infection or anaemia and performance on tests of cognitive function (sustained attention) or psychomotor function (VO2 max). However, a history of malaria in the past one month was significantly associated with decreased cognitive scores (aOR = -4.1, 95% CI -7.7–0.6, p = 0.02). Furthermore, stunted children had significantly lower VO2max scores (aOR = -1.9, 95% CI -3.0–0.8, p = 0.001). Regarding the antimalarial drug resistance markers, the most prevalent Pfmdr1 86-184-1034-1042-1246 haplotypes were the NFSND in 47% (n = 88) and the NYSND in 52% (n = 98). The wild type Pfcrt haplotypes (codons 72–76, CVMNK) were found in 99.1% (n = 219) of the samples. Malaria, stunting and parents’ or guardians’ illiteracy were the key attributable factors for anaemia in schoolchildren. Given malaria infection in schoolchildren is mostly asymptomatic; an addition of interventional programmes such as intermittent preventive treatment of malaria in schoolchildren (IPTsc) would probably act as a potential solution while calling for an improvement in the current tools such as bednet use, school food programme, and community-based (customised) health education with an emphasis on nutrition and malaria control.

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Section: Methodsmentioning

confidence: 99%

“…haematobium . Technical aspects of blood testing and other assessment are detailed on the study protocol [ 29 ].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Attributable risk factors for asymptomatic malaria and anaemia and their association with cognitive and psychomotor functions in schoolchildren of north-eastern Tanzania

et al. 2022

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“…Malaria morbidity and mortality among children have been attributed to insu cient protective immunity to protect them from the severe forms of the disease [36]. Malaria prevention, prompt disease detection and appropriate treatment which are important to resolve and restore child health depend on guardians' socio-demographic factors [37,38].…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Malaria Morbidity and Mortality Among Under 15 Years Children in Parts of Ghana: The Role of Guardians’ Socio-Demographic Characteristics Demonstrated Through Modelling

Asare

2021

Preprint

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Background To understand the underlying factors that led to failure to achieve the millennium development goal 6c by Ghana, we modelled guardians’ socio-demographic characteristics and the factors that could influence child health to provide directions for improving anti-malaria interventions in Ghana and sub-Sahara Africa.Methods Clinical data of 274 malaria patients, age up to 15 years, were collected from a cross-sectional study conducted in two districts in the central region of Ghana. Guardians of the children were interviewed to obtain socio-demographic characteristics and factors that could influence child health. The data obtained were analysed using multivariate GLM, type III ANOVA and multilayer perceptron network analysis.Results Of the 274 children enrolled into the study, 69.34% were between the age of 0-5 years. The median parasite density, haemoglobin and platelet were 89,923 (64,056-149,541) parasites/mm3, 8.40 (4.70-11.60) g/dL and 126 (87-146) x10^9/L respectively. 12.41% of the enrolled children had severe clinical conditions. The outcome using multivariate GLM analysis indicate a significant association between the guardians’ socio-demographic characteristics and factors that influence child health, p<0.0001. CSOC, FPOCCH, DOOSCS, and CS were all influenced by the guardians’ occupational status, p<0.0001; CSOC and MCID were influenced by the guardians’ educational levels, p<0.0001 and FPOCCH and MCID were also influenced by guardians age category, p<0.0001. The multilayer perceptron network analysis showed that the association between guardians’ socio-demographic characteristics and factors that influence child health are affected by several hidden confounding factors.Conclusion It was demonstrated an association between factors that influence child health care and guardians’ socio-demographic characteristics and this is confounded by hidden socio-economic factors and biases through modelling. I, therefore, propose a model called a network of socio-economic progenitors to provide a simple explanation for the underlying factors that influence child health in malaria-endemic areas.

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Lack of selection of antimalarial drug resistance markers after intermittent preventive treatment of schoolchildren (IPTsc) against malaria in northeastern Tanzania

Von Wowern,

Makenga,

Wellmann Thomsen

et al. 2024

International Journal of Infectious Diseases

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Cited by 11 publications

References 66 publications

Attributable risk factors for asymptomatic malaria and anaemia and their association with cognitive and psychomotor functions in schoolchildren of north-eastern Tanzania

Attributable risk factors for asymptomatic malaria and anaemia and their association with cognitive and psychomotor functions in schoolchildren of north-eastern Tanzania

Factors Influencing Malaria Morbidity and Mortality Among Under 15 Years Children in Parts of Ghana: The Role of Guardians’ Socio-Demographic Characteristics Demonstrated Through Modelling

Lack of selection of antimalarial drug resistance markers after intermittent preventive treatment of schoolchildren (IPTsc) against malaria in northeastern Tanzania

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