Two-Year Scale-Up of Seasonal Malaria Chemoprevention Reduced Malaria Morbidity among Children in the Health District of Koutiala, Mali

Hamma Maiga, Jean Gaudart, Issaka Sagara, Modibo Diarra, Amadou Bamadio, Moussa Djimde, Samba Coumare, Boubou Sangare, Yeyia Dicko, Aly Tembely, Djibril Traore, Alassane Dicko, Estrella Lasry, Ogobara Doumbo and Abdoulaye A. Djimde
Additional contact information
Hamma Maiga: Institut National de Santé Publique, Bamako BP: 1771, Mali
Jean Gaudart: Aix Marseille Univ, APHM, IRD, INSERM, UMR1252 SESSTIM Sciences Economiques & Sociales de la Santé & Traitement de l’Information Médicale, Hop Timone, BioSTIC, Biostatistic & ICT, 13385 Marseille, France
Issaka Sagara: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Modibo Diarra: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Amadou Bamadio: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Moussa Djimde: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Samba Coumare: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Boubou Sangare: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Yeyia Dicko: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Aly Tembely: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Djibril Traore: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Alassane Dicko: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Estrella Lasry: Médecins Sans Frontières (MSF), New York, NY 10006, USA
Ogobara Doumbo: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali
Abdoulaye A. Djimde: Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine and Dentistry, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako BP: 1805, Mali

IJERPH, 2020, vol. 17, issue 18, 1-10

Abstract: Background: Previous controlled studies demonstrated seasonal malaria chemoprevention (SMC) reduces malaria morbidity by >80% in children aged 3–59 months. Here, we assessed malaria morbidity after large-scale SMC implementation during a pilot campaign in the health district of Koutiala, Mali. Methods: Starting in August 2012, children received three rounds of SMC with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ). From July 2013 onward, children received four rounds of SMC. Prevalence of malaria infection, clinical malaria and anemia were assessed during two cross-sectional surveys conducted in August 2012 and June 2014. Investigations involved 20 randomly selected clusters in 2012 against 10 clusters in 2014. Results: Overall, 662 children were included in 2012, and 670 in 2014. Children in 2014 versus those surveyed in 2012 showed reduced proportions of malaria infection (12.4% in 2014 versus 28.7% in 2012 ( p = 0.001)), clinical malaria (0.3% versus 4.2%, respectively ( p < 0.001)), and anemia (50.1% versus 67.4%, respectively ( p = 0.001)). A propensity score approach that accounts for environmental differences showed that SMC conveyed a significant protective effect against malaria infection (IR = 0.01, 95% CI (0.0001; 0.09), clinical malaria (OR = 0.25, 95% CI (0.06; 0.85)), and hemoglobin concentration (β = 1.3, 95% CI (0.69; 1.96)) in 2012 and 2014, respectively. Conclusion: SMC significantly reduced frequency of malaria infection, clinical malaria and anemia two years after SMC scale-up in Koutiala.

Keywords: malaria; morbidity; seasonal malaria chemoprevention; Mali (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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