Seasonal Malaria Chemoprevention: An Evolving Research Paradigm

Snow, Robert W.

doi:10.1371/journal.pmed.1002176

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…In this setting in rural Burkina Faso during the lean season, dietary diversity appeared to be a modifiable risk factor for stunting and chronic malnutrition, particularly among younger children. Interventions that address dietary diversity, such as unconditional cash transfers, community-based caregiver nutritional education 34 or promotion of improved infant and young child feeding practices, 35 should be considered in rural sub-Sahelian regions with seasonal malnutrition, as well as efforts to reduce the burden of infectious disease, such as seasonal malaria chemoprevention 36,37 or integrated community case management. 38 Improving dietary diversity will likely have greater effects on longer-term chronic malnutrition than acute malnutrition.…”

Section: Discussionmentioning

confidence: 99%

Dietary diversity and nutritional status among children in rural Burkina Faso

Sié

Tapsoba

Dah

et al. 2018

International Health

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Section: Discussionmentioning

confidence: 99%

Dietary diversity and nutritional status among children in rural Burkina Faso

Sié

Tapsoba

Dah

et al. 2018

International Health

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“…A systematic review in 2011 identified 48 studies that evaluated the cost-effectiveness of malaria interventions [ 11 ], of which only two [ 10 , 12 ], were conducted among school-aged populations; as well as a cost analysis of a more recent school-based intervention in Kenya [ 13 ]. Better understanding the financial and economic costs of school-based interventions will help to inform ongoing questions of whether malaria control programmes can be channelled through schools, particularly in light of the availability of new preventive strategies such as seasonal malaria chemoprevention [ 14 , 15 ], and whether integrated programmes rather than single interventions should be implemented [ 10 , 13 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali

et al. 2017

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BackgroundThe expansion of malaria prevention and control to school-aged children is receiving increasing attention, but there are still limited data on the costs of intervention. This paper analyses the costs of a comprehensive school-based intervention strategy, delivered by teachers, that included participatory malaria educational activities, distribution of long lasting insecticide-treated nets (LLIN), and Intermittent Parasite Clearance in schools (IPCs) in southern Mali.MethodsCosts were collected alongside a randomised controlled trial conducted in 80 primary schools in Sikasso Region in Mali in 2010-2012. Cost data were compiled between November 2011 and March 2012 for the 40 intervention schools (6413 children). A provider perspective was adopted. Using an ingredients approach, costs were classified by cost category and by activity. Total costs and cost per child were estimated for the actual intervention, as well as for a simpler version of the programme more suited for scale-up by the government. Univariate sensitivity analysis was performed.ResultsThe economic cost of the comprehensive intervention was estimated to $10.38 per child (financial cost $8.41) with malaria education, LLIN distribution and IPCs costing $2.13 (20.5%), $5.53 (53.3%) and $2.72 (26.2%) per child respectively. Human resources were found to be the key cost driver, and training costs were the greatest contributor to overall programme costs. Sensitivity analysis showed that an adapted intervention delivering one LLIN instead of two would lower the economic cost to $8.66 per child; and that excluding LLIN distribution in schools altogether, for example in settings where malaria control already includes universal distribution of LLINs at community-level, would reduce costs to $4.89 per child.ConclusionsA comprehensive school-based control strategy may be a feasible and affordable way to address the burden of malaria among schoolchildren in the Sahel.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-017-4490-6) contains supplementary material, which is available to authorized users.

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“…It has been demonstrated in sub-Saharan Africa that seasonal malaria chemoprophylaxis (SMC) of children, the highest risk group for malaria in tropical Africa, can reduce malaria cases by 75%, is cost effective and safe and can be given by community health workers. 14 15 We propose to provide chemoprophylaxis to forest workers, the population group with the highest malaria risk in the GMS. In the proposed study, we compare chemoprophylaxis with an antimalarial drug, artemether-lumefantrine (AL) to a control agent, multivitamins.…”

Section: Introductionmentioning

confidence: 99%

Study protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in Cambodia

et al. 2021

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IntroductionIn the Greater Mekong Subregion, adults are at highest risk for malaria. The most relevant disease vectors bite during daytime and outdoors which makes forest work a high-risk activity for malaria. The absence of effective vector control strategies and limited periods of exposure during forest visits suggest that chemoprophylaxis could be an appropriate strategy to protect forest goers against malaria.Methods and analysisThe protocol describes an open-label randomised controlled trial of artemether-lumefantrine (AL) versus multivitamin as prophylaxis against malaria among forest goers aged 16–65 years in rural northeast Cambodia. The primary objective is to compare the efficacy of the artemisinin combination therapy AL versus a multivitamin preparation as defined by the 28-day PCR parasite positivity rate and incidence of confirmed clinical malaria of any species. The sample size is 2200 patient-episodes of duration 1 month in each arm. The duration of follow-up and prophylaxis for each participant is 1, 2 or 3 consecutive 28-day periods, followed by a further 28 days of post-exposure prophylaxis, depending on whether they continue to visit the forest. Analysis will be done both by intention to treat and per protocol.Ethics and disseminationAll participants will provide written, informed consent. Ethical approval was obtained from the Oxford Tropical Research Ethics Committee and the Cambodia National Ethics Committee for Health Research. Results will be disseminated by peer-reviewed open access publication together with open data.Trial registration numberNCT04041973; Pre-result.

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Seasonal Malaria Chemoprevention: An Evolving Research Paradigm

Abstract: Robert W. Snow discusses the importance of empirical evidence, such as that provided in the trial published this week by Milligan and colleagues, in guiding malaria control in Africa.

Cited by 4 publications

References 13 publications

Dietary diversity and nutritional status among children in rural Burkina Faso

Dietary diversity and nutritional status among children in rural Burkina Faso

Cost analysis of a school-based comprehensive malaria program in primary schools in Sikasso region, Mali

Study protocol: an open-label individually randomised controlled trial to assess the efficacy of artemether-lumefantrine prophylaxis for malaria among forest goers in Cambodia

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