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Randomized Controlled Trial
. 2020 Mar 3;19(1):103.
doi: 10.1186/s12936-020-03175-y.

Impact of seasonal malaria chemoprevention on hospital admissions and mortality in children under 5 years of age in Ouelessebougou, Mali

Djibrilla Issiaka  1 , Amadou Barry  1 , Tiangoua Traore  1 , Boubacar Diarra  2 , David Cook  3 , Mohamed Keita  4 , Issaka Sagara  1 , Patrick Duffy  3 , Michal Fried  3 , Alassane Dicko  5
Affiliations
Randomized Controlled Trial

Impact of seasonal malaria chemoprevention on hospital admissions and mortality in children under 5 years of age in Ouelessebougou, Mali

Djibrilla Issiaka et al. Malar J. .

Abstract

Background: Seasonal malaria chemoprevention is widely implemented in Sahel and sub-Sahel countries in Africa. Few studies have assessed the impact of the SMC on hospital admission and death when it is implemented in the health system. This retrospective study assessed the impact of seasonal malaria chemoprevention (SMC) on hospitalizations and deaths of children under 5 years of age during the second year of implementation of SMC in the health district of Ouelessebougou in Mali.

Methods: In February 2017, a survey was conducted to assess hospital admissions and deaths in children under 5 years of age in two health sub-districts where SMC was implemented in 2015 and two health sub-districts where SMC was not implemented. The survey reviewed deaths and hospitalizations of children under 5, in the four health sub-districts. The crude and specific incidence rates of hospitalizations and deaths were determined in both groups and expressed per 1000 children per year. A negative binomial regression model and a Cox model were used to estimate the relative risks of hospitalization and death after adjusting for confounders. The R software was used for data analysis.

Results: A total of 6638 children under 5 years of age were surveyed, 2759 children in the SMC intervention areas and 3879 children in the control areas. All causes mortality rate per 1000 person-years was 8.29 in the control areas compared to 3.63 in the intervention areas; age and gender adjusted mortality rate ratio 0.44 (95% CI 0.22-0.91), p = 0.027. The incidence rate of all causes hospital admissions was 19.60 per 1000 person-years in the intervention group compared to 33.45 per 1000 person-years in the control group, giving an incidence rate ratio (IRR) adjusted for age and gender of 0.61 (95% CI 0.44-0.84), p = 0.003.

Conclusion: The implementation of SMC was associated with a substantial reduction in hospital admissions and all-cause mortality. Trial registration ClinicalTrials.gov NCT02646410.

Keywords: Death; Hospitalization; Malaria; Mali; Seasonal malaria chemoprevention.

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Conflict of interest statement

The authors declare that they have no competing interests.

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References

    1. Gething PW, Casey DC, Weiss DJ, Bisanzio D, Bhatt S, Cameron E, et al. Mapping Plasmodium falciparum mortality in Africa between 1990 and 2015. N Engl J Med. 2016;375:2435–2445. doi: 10.1056/NEJMoa1606701. - DOI - PMC - PubMed
    1. WHO. Policy recommendation: seasonal malaria chemoprevention (SMC) for Plasmodium falciparum malaria control in highly seasonal transmission areas of the Sahel sub-region in Africa. Geneva: World Health Organization; 2012. (In English and French). http://www.who.int/malaria/publications/atoz/who_smc_policy_recommendati.... Accessed 2012 Sep 16.
    1. Wilson AL. A systematic review and meta-analysis of the efficacy and safety of intermittent preventive treatment of malaria in children (IPTc) PLoS ONE. 2011;6:e16976. doi: 10.1371/journal.pone.0016976. - DOI - PMC - PubMed
    1. Cairns M, Roca-Feltrer A, Garske T, Wilson AL, Diallo D, Milligan PJ, et al. Estimating the potential public health impact of seasonal malaria chemoprevention in African children. Nat Commun. 2012;3:881. doi: 10.1038/ncomms1879. - DOI - PMC - PubMed
    1. Cellule de Planification et de Statistiques (SMC/SSDSPF); Institut National de la Statistique (INSTAT); Centre d’Études et d’Information Statistiques (INFO-STAT) Bamako, Mali; ICF International Rockville, Maryland, USA. Enquête démographique et de santé (EDSM V). Mai 2014; 577p.

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