LIVIVO - Search results -

Search results

Result 1 - 10 of total 78

Search options

Article ; Online: Estimating the burden of severe malarial anaemia and access to hospital care in East Africa.

Winskill, Peter / Dhabangi, Aggrey / Kwambai, Titus K / Mori, Amani Thomas / Mousa, Andria / Okell, Lucy C

2023 Volume 14, Issue 1, Page(s) 5691

Abstract: Severe malarial anaemia can be fatal if not promptly treated. Hospital studies may under-represent the true burden because cases often occur in settings with poor access to healthcare. We estimate the relationship of community prevalence of malaria ... ...

Abstract	Severe malarial anaemia can be fatal if not promptly treated. Hospital studies may under-represent the true burden because cases often occur in settings with poor access to healthcare. We estimate the relationship of community prevalence of malaria infection and severe malarial anaemia with the incidence of severe malarial anaemia cases in hospital, using survey data from 21 countries and hospital data from Kenya, Tanzania and Uganda. The estimated percentage of severe malarial anaemia cases that were hospitalised is low and consistent for Kenya (21% (95% CrI: 7%, 47%)), Tanzania (18% (95% CrI: 5%, 52%)) and Uganda (23% (95% CrI: 9%, 48%)). The majority of severe malarial anaemia cases remain in the community, with the consequent public health burden being contingent upon the severity of these cases. Alongside health system strengthening, research to better understand the spectrum of disease associated with severe malarial anaemia cases in the community is a priority.
MeSH term(s)	Humans ; Kenya/epidemiology ; Tanzania/epidemiology ; Anemia/epidemiology ; Malaria/complications ; Malaria/epidemiology ; Hospitals
Language	English
Publishing date	2023-09-14
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2553671-0
ISSN	2041-1723 ; 2041-1723
ISSN (online)	2041-1723
ISSN	2041-1723
DOI	10.1038/s41467-023-41275-w
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

Article ; Online: Asymptomatic recrudescence after artemether-lumefantrine treatment for uncomplicated falciparum malaria: a systematic review and meta-analysis.

Mumtaz, Rida / Okell, Lucy C / Challenger, Joseph D

Malaria journal

2020 Volume 19, Issue 1, Page(s) 453

Abstract: Background: In clinical trials of therapy for uncomplicated Plasmodium falciparum, there are usually some patients who fail treatment even in the absence of drug resistance. Treatment failures, which can be due to recrudescence or re-infection, are ... ...

Abstract	Background: In clinical trials of therapy for uncomplicated Plasmodium falciparum, there are usually some patients who fail treatment even in the absence of drug resistance. Treatment failures, which can be due to recrudescence or re-infection, are categorized as 'clinical' or 'parasitological' failures, the former indicating that symptoms have returned. Asymptomatic recrudescence has public health implications for continued malaria transmission and may be important for the spread of drug-resistant malaria. As the number of recrudescences in an individual trial is often low, it is difficult to assess how commonplace asymptomatic recrudescence is, and with what factors it is associated. Methods: A systematic literature review was carried out on clinical trials of artemether-lumefantrine (AL) in patients seeking treatment for symptomatic uncomplicated falciparum malaria, and information on symptoms during treatment failure was recorded. Only treatment failures examined by polymerase chain reaction (PCR) were included, so as to exclude re-infections. A multivariable Bayesian regression model was used to explore factors potentially explaining the proportion of recrudescent infections which are symptomatic across the trials included in the study. Results: Across 60 published trials, including 9137 malaria patients, 37.8% [95% CIs (26.6-49.4%)] of recrudescences were symptomatic. A positive association was found between transmission intensity and the observed proportion of recrudescences that were asymptomatic. Symptoms were more likely to return in trials that only enrolled children aged < 72 months [odds ratio = 1.62, 95% CIs (1.01, 2.59)]. However, 84 studies had to be excluded from this analysis, as recrudescences were not specified as symptomatic or asymptomatic. Conclusions: AL, the most widely used treatment for uncomplicated P. falciparum in Africa, remains a highly efficacious drug in most endemic countries. However in the small proportion of patients where AL does not clear parasitaemia, the majority of patients do not develop symptoms again and thus would be unlikely to seek another course of treatment. This continued asymptomatic parasite carriage in patients who have been treated may have implications for drug-resistant parasites being introduced into high-transmissions settings.
MeSH term(s)	Antimalarials/adverse effects ; Antimalarials/therapeutic use ; Artemether, Lumefantrine Drug Combination/adverse effects ; Artemether, Lumefantrine Drug Combination/therapeutic use ; Asymptomatic Infections ; Child ; Child, Preschool ; Humans ; Infant ; Infant, Newborn ; Malaria, Falciparum/drug therapy ; Malaria, Falciparum/epidemiology ; Recurrence ; Treatment Failure
Chemical Substances	Antimalarials ; Artemether, Lumefantrine Drug Combination
Language	English
Publishing date	2020-12-09
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ISSN	1475-2875
ISSN (online)	1475-2875
DOI	10.1186/s12936-020-03520-1
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article: Selection of artemisinin partial resistance Kelch13 mutations in Uganda in 2016-22 was at a rate comparable to that seen previously in South-East Asia.

Meier-Scherling, Cecile P G / Watson, Oliver J / Asua, Victor / Ghinai, Isaac / Katairo, Thomas / Garg, Shreeya / Conrad, Melissa / Rosenthal, Philip J / Okell, Lucy C / Bailey, Jeffrey A

medRxiv : the preprint server for health sciences

2024

Abstract: Background: Artemisinin partial resistance, mediated by mutations in the : Methods: We investigated K13 mutation prevalence at 16 sites in Uganda (2016-2022, 6586 samples), and five sites in SEA (2003-2018, 5465 samples) by calculating selection ... ...

Abstract	Background: Artemisinin partial resistance, mediated by mutations in the Methods: We investigated K13 mutation prevalence at 16 sites in Uganda (2016-2022, 6586 samples), and five sites in SEA (2003-2018, 5465 samples) by calculating selection coefficients using Bayesian mixed-effect linear models. We then tested whether SEA K13 mutation prevalence could have been forecast accurately using up to the first five years of available data and forecast future K13 mutation prevalence in Uganda. Findings: The selection coefficient for the prevalence of relevant K13 mutations (441L, 469F/Y, 561H, 675V) was estimated at s=0·383 (95% CrI: 0·247 - 0·528) per year, a 38% relative prevalence increase. Selection coefficients across Uganda were s=0·968 (0·463 - 1·569) for 441L, s=0·153 (-0·445 - 0·727) for 469F, s=0·222 (-0·011 - 0·398) for 469Y, and s=0·152 (-0·023 - 0·312) for 675V. In SEA, the selection coefficient was s=-0·005 (-0·852 - 0·814) for 539T, s=0·574 (-0·092 - 1·201) for 580Y, and s=0·308 (0·089 - 0·536) for all validated K13 mutations. Forecast prevalences for Uganda assuming constant selection neared fixation (>95% prevalence) within a decade (2028-2033) for combined K13 mutations. Interpretation: The selection of K13 mutations in Uganda was at a comparable rate to that observed in SEA, suggesting K13 mutations may continue to increase quickly in Uganda. Funding: NIH R01AI156267, R01AI075045, and R01AI089674.
Language	English
Publishing date	2024-02-04
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.02.03.24302209
Database	MEDical Literature Analysis and Retrieval System OnLINE

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Details ▾

Article ; Online: Does integrated community case management (iCCM) target health inequities and treatment delays? Evidence from an analysis of Demographic and Health Surveys data from 21 countries in the period 2010 to 2018.

Winskill, Peter / Mousa, Andria / Oresanya, Olusola / Counihan, Helen / Okell, Lucy C / Walker, Patrick G

Journal of global health

2021 Volume 11, Page(s) 4013

Abstract: Background: Integrated community case management (iCCM) is a programme that can, via community health workers (CHWs), increase access to timely and essential treatments for children. As well as improving treatment coverage, iCCM has an additional equity- ...

Abstract	Background: Integrated community case management (iCCM) is a programme that can, via community health workers (CHWs), increase access to timely and essential treatments for children. As well as improving treatment coverage, iCCM has an additional equity-focus with the aim of targeting underserved populations. To assess the success of iCCM programmes it is important that we understand the contribution they are making to equitable health coverage. Methods: We analysed demographic and health survey data from 21 countries over 9 years to assess evidence and evaluate iCCM programmes. We summarise the contribution CHWs are making relative to other health care provider groups and what treatment combinations CHWs are commonly prescribing. We assessed the ability of CHWs to target treatment delays and health inequities by evaluating time to treatment following fever onset and relationships between CHWs and wealth, rurality and remoteness. Results: There was good evidence that CHWs are being successfully targeted to improve inequities in health care coverage. There is a larger contribution of CHWs in areas with higher poverty, rurality and remoteness. In six surveys CHWs were associated with significantly shorter average time between fever onset and advice or treatment seeking, whilst in one they were associated with significantly longer times. In areas with active CHW programmes, the contribution of CHWs relative to other health care provider groups varied between 11% to 45% of treatment visits. The distribution of types of treatment provided by CHWs was also very variable between countries. Conclusions: The success of an iCCM programme depends not only on increasing treatment coverage but addressing inequities in access to timely health care. Whilst much work is still needed to attain universal health care targets, and despite incomplete data, there is evidence that iCCM is successfully addressing treatment delays and targeting underserved populations.
MeSH term(s)	Case Management ; Child ; Community Health Workers ; Demography ; Humans ; Rural Population ; Time-to-Treatment
Language	English
Publishing date	2021-03-01
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	2741629-X
ISSN	2047-2986 ; 2047-2986
ISSN (online)	2047-2986
ISSN	2047-2986
DOI	10.7189/jogh.11.04013
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Mapping sulphadoxine-pyrimethamine-resistant Plasmodium falciparum malaria in infected humans and in parasite populations in Africa.

Okell, Lucy C / Griffin, Jamie T / Roper, Cally

Scientific reports

2017 Volume 7, Issue 1, Page(s) 7389

Abstract: Intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine in vulnerable populations reduces malaria morbidity in Africa, but resistance mutations in the parasite dhps gene (combined with dhfr mutations) threaten its efficacy. We update a ... ...

Abstract	Intermittent preventive treatment (IPT) with sulphadoxine-pyrimethamine in vulnerable populations reduces malaria morbidity in Africa, but resistance mutations in the parasite dhps gene (combined with dhfr mutations) threaten its efficacy. We update a systematic review to map the prevalence of K540E and A581G mutations in 294 surveys of infected humans across Africa from 2004-present. Interpreting these data is complicated by multiclonal infections in humans, especially in high transmission areas. We extend statistical methods to estimate the frequency, i.e. the proportion of resistant clones in the parasite population at each location, and so standardise for varying transmission levels. Both K540E and A581G mutations increased in prevalence and frequency in 60% of areas after 2008, highlighting the need for ongoing surveillance. Resistance measures within countries were similar within 300 km, suggesting an appropriate spatial scale for surveillance. Spread of the mutations tended to accelerate once their prevalence exceeded 10% (prior to fixation). Frequencies of resistance in parasite populations are the same or lower than prevalence in humans, so more areas would be classified as likely to benefit from IPT if similar frequency thresholds were applied. We propose that the use of resistance frequencies as well as prevalence measures for policy decisions should be evaluated.
MeSH term(s)	Africa/epidemiology ; Animals ; Antimalarials/pharmacology ; Dihydropteroate Synthase/genetics ; Drug Combinations ; Drug Resistance ; Humans ; Malaria, Falciparum/epidemiology ; Malaria, Falciparum/parasitology ; Malaria, Falciparum/veterinary ; Models, Statistical ; Mutation ; Plasmodium falciparum/drug effects ; Plasmodium falciparum/genetics ; Population Surveillance ; Prevalence ; Protozoan Proteins/genetics ; Pyrimethamine/pharmacology ; Sulfadoxine/pharmacology ; Tetrahydrofolate Dehydrogenase/genetics
Chemical Substances	Antimalarials ; Drug Combinations ; Protozoan Proteins ; fanasil, pyrimethamine drug combination (37338-39-9) ; Sulfadoxine (88463U4SM5) ; DHFR protein, Plasmodium falciparum (EC 1.5.1.3) ; Tetrahydrofolate Dehydrogenase (EC 1.5.1.3) ; Dihydropteroate Synthase (EC 2.5.1.15) ; Pyrimethamine (Z3614QOX8W)
Language	English
Publishing date	2017-08-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-017-06708-9
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article ; Online: Global patterns of submicroscopic

Whittaker, Charles / Slater, Hannah / Nash, Rebecca / Bousema, Teun / Drakeley, Chris / Ghani, Azra C / Okell, Lucy C

The Lancet. Microbe

2021 Volume 2, Issue 8, Page(s) e366–e374

Abstract: Background: Adoption of molecular techniques to detect : Methods: In this systematic review and meta-analysis we searched PubMed and Web of Science from Jan 1, 2010, until Oct 11, 2020, for cross-sectional studies reporting data on asexual : ... ...

Abstract	Background: Adoption of molecular techniques to detect Methods: In this systematic review and meta-analysis we searched PubMed and Web of Science from Jan 1, 2010, until Oct 11, 2020, for cross-sectional studies reporting data on asexual Findings: Of 4893 identified studies, we retained 121 after screening and removal of duplicates. 45 studies from a previous systematic review were included giving 166 studies containing 551 cross-sectional survey microscopy and PCR prevalence pairs. Our results show that submicroscopic infections predominate in low-transmission settings across all regions, but also reveal marked geographical variation, with the proportion of infections that are submicroscopic being highest in South American surveys and lowest in west African surveys. Although current transmission levels partly explain these results, we find that historical transmission intensity also represents a crucial determinant of the size of the submicroscopic reservoir, as does the demographic structure of the infected population (with submicroscopic infection more likely to occur in adults than in children) and the PCR or microscopy methodology used. We also observed a small yet significant influence of seasonality, with fewer submicroscopic infections observed in the wet season than the dry season. Integrating these results with estimates of infectivity in relation to parasite density suggests the contribution of submicroscopic infections to transmission across different settings is likely to be highly variable. Interpretation: Significant variation in the prevalence of submicroscopic infection exists even across settings characterised by similar current levels of transmission. These differences in submicroscopic epidemiology potentially warrant different approaches to targeting this infected subgroup across different settings to eliminate malaria. Funding: Bill & Melinda Gates Foundation, The Royal Society, and the UK Medical Research Council.
MeSH term(s)	Adult ; Bayes Theorem ; Child ; Cross-Sectional Studies ; Female ; Humans ; Malaria/diagnosis ; Malaria, Falciparum/epidemiology ; Plasmodium falciparum/genetics ; Pregnancy
Language	English
Publishing date	2021-08-11
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Systematic Review
ISSN	2666-5247
ISSN (online)	2666-5247
DOI	10.1016/S2666-5247(21)00055-0
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Mathematical Modelling to Guide Drug Development for Malaria Elimination.

Slater, Hannah C / Okell, Lucy C / Ghani, Azra C

Trends in parasitology

2016 Volume 33, Issue 3, Page(s) 175–184

Abstract: Mathematical models of the dynamics of a drug within the host are now frequently used to guide drug development. These generally focus on assessing the efficacy and duration of response to guide patient therapy. Increasingly, antimalarial drugs are used ... ...

Abstract	Mathematical models of the dynamics of a drug within the host are now frequently used to guide drug development. These generally focus on assessing the efficacy and duration of response to guide patient therapy. Increasingly, antimalarial drugs are used at the population level, to clear infections, provide chemoprevention, and to reduce onward transmission of infection. However, there is less clarity on the extent to which different drug properties are important for these different uses. In addition, the emergence of drug resistance poses new threats to longer-term use and highlights the need for rational drug development. Here, we argue that integrating within-host pharmacokinetic and pharmacodynamic (PK/PD) models with mathematical models for the population-level transmission of malaria is key to guiding optimal drug design to aid malaria elimination.
MeSH term(s)	Antimalarials/pharmacology ; Antimalarials/therapeutic use ; Disease Eradication ; Drug Design ; Drug Resistance ; Humans ; Malaria, Falciparum/drug therapy ; Models, Theoretical ; Plasmodium falciparum
Chemical Substances	Antimalarials
Language	English
Publishing date	2016-10-07
Publishing country	England
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2036227-4
ISSN	1471-5007 ; 1471-4922
ISSN (online)	1471-5007
ISSN	1471-4922
DOI	10.1016/j.pt.2016.09.004
Database	MEDical Literature Analysis and Retrieval System OnLINE

In stock of ZB MED Cologne/Königswinter

Zs.B 2898: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MG 16: Show issues
Zs.MO 251: Show issues

Order via subito

Details ▾
- See ZB MED holdings
- Order with fees

Article ; Online: Assessing the impact of imperfect adherence to artemether-lumefantrine on malaria treatment outcomes using within-host modelling.

Challenger, Joseph D / Bruxvoort, Katia / Ghani, Azra C / Okell, Lucy C

Nature communications

2017 Volume 8, Issue 1, Page(s) 1373

Abstract: Artemether-lumefantrine (AL) is the most widely-recommended treatment for uncomplicated Plasmodium falciparum malaria worldwide. Its safety and efficacy have been extensively demonstrated in clinical trials; however, its performance in routine health ... ...

Abstract	Artemether-lumefantrine (AL) is the most widely-recommended treatment for uncomplicated Plasmodium falciparum malaria worldwide. Its safety and efficacy have been extensively demonstrated in clinical trials; however, its performance in routine health care settings, where adherence to drug treatment is unsupervised and therefore may be suboptimal, is less well characterised. Here we develop a within-host modelling framework for estimating the effects of sub-optimal adherence to AL treatment on clinical outcomes in malaria patients. Our model incorporates the data on the human immune response to the parasite, and AL's pharmacokinetic and pharmacodynamic properties. Utilising individual-level data of adherence to AL in 482 Tanzanian patients as input for our model predicted higher rates of treatment failure than were obtained when adherence was optimal (9% compared to 4%). Our model estimates that the impact of imperfect adherence was worst in children, highlighting the importance of advice to caregivers.
MeSH term(s)	Antimalarials/pharmacokinetics ; Antimalarials/therapeutic use ; Artemisinins/pharmacokinetics ; Artemisinins/therapeutic use ; Drug Combinations ; Ethanolamines/pharmacokinetics ; Ethanolamines/therapeutic use ; Fluorenes/pharmacokinetics ; Fluorenes/therapeutic use ; Host-Parasite Interactions/drug effects ; Humans ; Malaria, Falciparum/drug therapy ; Models, Biological ; Patient Compliance ; Tanzania ; Treatment Outcome
Chemical Substances	Antimalarials ; Artemisinins ; Drug Combinations ; Ethanolamines ; Fluorenes ; artemether-lumefantrine combination
Language	English
Publishing date	2017-11-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2041-1723
ISSN (online)	2041-1723
DOI	10.1038/s41467-017-01352-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

Article ; Online: Modelling the benefits of long-acting or transmission-blocking drugs for reducing Plasmodium falciparum transmission by case management or by mass treatment.

Bretscher, Michael T / Griffin, Jamie T / Ghani, Azra C / Okell, Lucy C

Malaria journal

2017 Volume 16, Issue 1, Page(s) 341

Abstract: Background: Anti-malarial drugs are an important tool for malaria control and elimination. Alongside their direct benefit in the treatment of disease, drug use has a community-level effect, clearing the reservoir of infection and reducing onward ... ...

Abstract	Background: Anti-malarial drugs are an important tool for malaria control and elimination. Alongside their direct benefit in the treatment of disease, drug use has a community-level effect, clearing the reservoir of infection and reducing onward transmission of the parasite. Different compounds potentially have different impacts on transmission-with some providing periods of prolonged chemoprophylaxis whilst others have greater transmission-blocking potential. The aim was to quantify the relative benefit of such properties for transmission reduction to inform target product profiles in the drug development process and choice of first-line anti-malarial treatment in different endemic settings. Methods: A mathematical model of Plasmodium falciparum epidemiology was used to estimate the transmission reduction that can be achieved by using drugs of varying chemoprophylactic (protection for 3, 30 or 60 days) or transmission-blocking activity (blocking 79, 92 or 100% of total onward transmission). Simulations were conducted at low, medium or high transmission intensity (slide-prevalence in 2-10 year olds being 1, 10 or 40%, respectively), with drugs administered either via case management or mass drug administration (MDA). Results: Transmission reductions depend strongly on deployment strategy, treatment coverage and endemicity level. Transmission-blocking was most effective at low endemicity, whereas chemoprophylaxis was most useful at high endemicity levels. Increasing the duration of protection as much as possible was beneficial. Increasing transmission-blocking activity from the level of ACT to a 100% transmission-blocking drug (close to the effect estimated for ACT combined with primaquine) produced moderate impact but was not as effective as increasing the duration of protection in medium-to-high transmission settings (slide prevalence 10-40%). Combining both good transmission-blocking activity (e.g. as achieved by ACT or ACT + primaquine) and a long duration of protection (30 days or more, such as provided by piperaquine or mefloquine) within a drug regimen can substantially increase impact compared with drug regimens with only one of these properties in medium to high transmission areas (slide-prevalence in 2-10 year olds ~10 to 40%). These results applied whether the anti-malarials were used for case management or for MDA. Discussion: These results emphasise the importance of increasing access to treatment for routine case management, and the potential value of choosing first-line anti-malarial treatment policies according to local malaria epidemiology to maximise impact on transmission. There is no indication that the optimal drug choice should differ between delivery via case management or MDA.
MeSH term(s)	Antimalarials/therapeutic use ; Case Management/statistics & numerical data ; Drug Therapy, Combination/statistics & numerical data ; Malaria, Falciparum/parasitology ; Malaria, Falciparum/prevention & control ; Malaria, Falciparum/transmission ; Mass Drug Administration/statistics & numerical data ; Models, Theoretical ; Plasmodium falciparum/drug effects
Chemical Substances	Antimalarials
Language	English
Publishing date	2017-08-16
Publishing country	England
Document type	Journal Article
ZDB-ID	2091229-8
ISSN	1475-2875 ; 1475-2875
ISSN (online)	1475-2875
ISSN	1475-2875
DOI	10.1186/s12936-017-1988-4
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Article: Impact of seasonal malaria chemoprevention on prevalence of malaria infection in malaria indicator surveys in Burkina Faso and Nigeria.

de Cola, Monica Anna / Sawadogo, Benoît / Richardson, Sol / Ibinaiye, Taiwo / Traoré, Adama / Compaoré, Cheick Saïd / Oguoma, Chibuzo / Oresanya, Olusola / Tougri, Gauthier / Rassi, Christian / Roca-Feltrer, Arantxa / Walker, Patrick / Okell, Lucy C

BMJ global health

2022 Volume 7, Issue 5

Abstract: Background: In 2012, the WHO issued a policy recommendation for the use of seasonal malaria chemoprevention (SMC) to children 3-59 months in areas of highly seasonal malaria transmission. Clinical trials have found SMC to prevent around 75% of clinical ... ...

Abstract	Background: In 2012, the WHO issued a policy recommendation for the use of seasonal malaria chemoprevention (SMC) to children 3-59 months in areas of highly seasonal malaria transmission. Clinical trials have found SMC to prevent around 75% of clinical malaria. Impact under routine programmatic conditions has been assessed during research studies but there is a need to identify sustainable methods to monitor impact using routinely collected data. Methods: Data from Demographic Health Surveys were merged with rainfall, geographical and programme data in Burkina Faso (2010, 2014, 2017) and Nigeria (2010, 2015, 2018) to assess impact of SMC. We conducted mixed-effects logistic regression to predict presence of malaria infection in children aged 6-59 months (rapid diagnostic test (RDT) and microscopy, separately). Results: We found strong evidence that SMC administration decreases odds of malaria measured by RDT during SMC programmes, after controlling for seasonal factors, age, sex, net use and other variables (Burkina Faso OR 0.28, 95% CI 0.21 to 0.37, p<0.001; Nigeria OR 0.40, 95% CI 0.30 to 0.55, p<0.001). The odds of malaria were lower up to 2 months post-SMC in Burkina Faso (1-month post-SMC: OR 0.29, 95% CI 0.12 to 0.72, p=0.01; 2 months post-SMC: OR: 0.33, 95% CI 0.17 to 0.64, p<0.001). The odds of malaria were lower up to 1 month post-SMC in Nigeria but was not statistically significant (1-month post-SMC 0.49, 95% CI 0.23 to 1.05, p=0.07). A similar but weaker effect was seen for microscopy (Burkina Faso OR 0.38, 95% CI 0.29 to 0.52, p<0.001; Nigeria OR 0.53, 95% CI 0.38 to 0.76, p<0.001). Conclusions: Impact of SMC can be detected in reduced prevalence of malaria from data collected through household surveys if conducted during SMC administration or within 2 months afterwards. Such evidence could contribute to broader evaluation of impact of SMC programmes.
MeSH term(s)	Antimalarials/therapeutic use ; Burkina Faso/epidemiology ; Chemoprevention/methods ; Child ; Humans ; Malaria/epidemiology ; Malaria/prevention & control ; Nigeria/epidemiology ; Prevalence ; Seasons
Chemical Substances	Antimalarials
Language	English
Publishing date	2022-05-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2059-7908
ISSN	2059-7908
DOI	10.1136/bmjgh-2021-008021
Database	MEDical Literature Analysis and Retrieval System OnLINE

Order via subito

Inter-library loan at ZB MED

Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

To top

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

In stock of ZB MED Cologne/Königswinter

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED

More links

Kategorien

Order via subito

More links

Kategorien

Order via subito

Inter-library loan at ZB MED