Predictors of caregiver adherence to administration of amodiaquine during delivery of seasonal malaria chemoprevention in Nigeria, Burkina Faso, Chad, and Togo

Ibinaiye, Taiwo; Oresanya, Olusola; Oguoma, Chibuzo; Aidenagbon, Adaeze; Ogunmola, Olabisi; Rassi, Christian; Richardson, Sol

doi:10.1186/s12936-023-04576-5

Cited by 4 publications

References 10 publications

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Malaria prevention in children: an update

Friedman-Klabanoff,

Adu-Gyasi,

Asante

2024

Current Opinion in Pediatrics

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Purpose of review Malaria cases and deaths decreased from 2000 to 2015 but remain increased since 2019. Several new developments and strategies could help reverse this trend. The purpose of this review is to discuss new World Health Organization (WHO) guidelines and recent research on malaria prevention in children. Recent findings Fifteen countries have now rolled out seasonal malaria chemoprophylaxis (SMC) in children at highest risk for severe malaria, and new WHO recommendations provide more flexibility for SMC implementation in terms of target age groups, geographic region, and number of cycles. Recent studies confirm that malaria burden in school aged children, and their contribution to transmission, is high. New guidelines permit expanded chemoprevention options for these children. Two vaccines have been approved for use in malaria endemic countries, RTS,S/AS01E and R21/Matrix-M. Additionally, pyrethroid-chlorfenapyr bed nets are being deployed to combat resistant mosquitoes. Summary While challenges remain in malaria control towards elimination, new guidelines and recently approved vaccines offer hope. Monitoring for continued vaccine and chemoprevention effectiveness, and for possible epidemiologic shifts in severe malaria presentation and deaths as additional prevention efforts roll out will be paramount.

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Malaria prevention in children: an update

Friedman-Klabanoff,

Adu-Gyasi,

Asante

2024

Current Opinion in Pediatrics

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Predictors of accessing seasonal malaria chemoprevention medicines through non-door-to-door distribution in Nigeria

Huang,

Baker,

Ibinaiye

et al. 2024

Malar J

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Background In Nigeria, seasonal malaria chemoprevention (SMC) is typically administered door-to-door to children under five by community medicine distributors during high transmission seasons. While door-to-door distribution (DDD) is exclusively employed in Nigeria as part of standard operating procedures of SMC programmes, some households access SMC through non-DDD channels, such as fixed-point distributions, health facilities, and private purchase. However, analysis of access to SMC medicines through non-DDD has been limited, with little evidence of its outcomes on adherence to the three-day complete course of SMC medicines and caregiver actions in the event of adverse reactions to SMC medicines. Methods Data were obtained from SMC end-of-round coverage surveys conducted in Nigeria in 2021 and 2022, including 25,278 households for the analysis. The proportion of households accessing SMC medicine through non-DDD and the distribution of various non-DDD sources of SMC medicines were described. Multivariate random-effects logistic regression models were performed to identify predictors of accessing SMC medicines through non-DDD. The associations between non-DDD, and caregiver-reporting of adherence to complete administration of SMC medicines and caregiver actions in the event of adverse reactions to SMC medicines were also assessed. Results Less than 2% (314/24003) of households accessed SMC medicines through non-DDD in the states surveyed. Over 60% of non-DDD access was via health facility personnel and community medicine distributors from different locations. Variables associated with non-DDD access included heads of household being born in the local state (OR = 0.68, 95% CI 0.47 to 0.90), households residing in the study state since the first cycle of the SMC round (OR = 0.39, 95% CI 0.17 to 0.88), households with high wealth index (OR = 1.36, 95% CI 1.01 to 1.82), and caregivers hearing about date of SMC delivery in the previous cycle (OR = 0.18, 95%CI 0.14 to 0.24). Furthermore, non-DDD was associated with reduced SMC adherence and higher caregiver non-reporting of adverse reactions to SMC medicines in children compared with DDD. Conclusion This study provides evidence on the characteristics of households accessing SMC medicines through non-DDD and its potential negative outcomes on adherence to SMC medicine and adverse reaction reporting, underscoring potential implementation issues that may arise if non-DDD delivery models are adopted in SMC, particularly in places where DDD had been firstly used.

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Results from phase one of a hybrid effectiveness-implementation study to assess the feasibility, acceptability and effectiveness of implementing seasonal malaria chemoprevention in Nampula province, Mozambique

Baker,

Tarquino,

Aide

et al. 2024

Preprint

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Introduction Seasonal malaria chemoprevention (SMC) is a highly effective intervention for malaria prevention in high burden areas with seasonal transmission, historically implemented in the Sahel. Mozambique contributes to 4% of global malaria cases, malaria being one of four major causes of mortality nationally. The mid-term review of the Malaria Strategic Plan 2017–2022 recommended SMC in Mozambique. Malaria Consortium, in partnership with the National Malaria Control Program, conducted a two-year phased SMC study in Nampula province using sulfadoxine-pyrimethamine (SP) plus amodiaquine (AQ), or SPAQ, in children under five. Phase one investigated acceptability, feasibility, and protective effect of SMC; while phase two, researched the effectiveness of SMC, chemoprevention efficacy and changes in resistance markers prevalence. The following references phase one results.Methods A pragmatic type II hybrid effectiveness-implementation study design was adopted, using mixed methods. The study was conducted in three districts, utilising: (1) non-randomised controlled trial; (2) drug resistance molecular marker study; (3) coverage and quality assessment; and (4) acceptability and feasibility assessment with stakeholders.Results Children who received SMC had 86% (hazard ratio 0.14, 95% CI: 0.09–0.24) lower hazards of developing clinical malaria during the peak transmission season compared with children in the comparison district. Prevalence of SP molecular markers associated with resistance was high at baseline (K540E 66.1%). However, a non-statistically significant trend of increasing prevalence was observed. SMC achieved high coverage of eligible children over four cycles (87.7%, 95% CI: 83.9%-90.8%). Qualitative results indicate SMC was positively accepted by the targeted community, with few negative opinions reported.Conclusions Results suggest that SMC was effective at preventing clinical malaria, did not significantly impact resistance profile, and was feasible and acceptable in the context. Phase two will assess SMC impact in reducing malaria incidence and if chemoprevention efficacy of SPAQ is impacted by drug resistance and drug concentrations.

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Predictors of caregiver adherence to administration of amodiaquine during delivery of seasonal malaria chemoprevention in Nigeria, Burkina Faso, Chad, and Togo

Cited by 4 publications

References 10 publications

Malaria prevention in children: an update

Malaria prevention in children: an update

Predictors of accessing seasonal malaria chemoprevention medicines through non-door-to-door distribution in Nigeria

Results from phase one of a hybrid effectiveness-implementation study to assess the feasibility, acceptability and effectiveness of implementing seasonal malaria chemoprevention in Nampula province, Mozambique

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