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Randomized Controlled Trial
. 2024 Jan 25;14(1):2143.
doi: 10.1038/s41598-024-52706-z.

Dihydroartemisinin-piperaquine effectiveness for seasonal malaria chemoprevention in settings with extended seasonal malaria transmission in Tanzania

Richard Mwaiswelo #  1 , Billy Ngasala #  2 , Frank Chaky  3 , Fabrizio Molteni  4 , Ally Mohamed  3 , Samwel Lazaro  3 , Bushukatale Samwel  2 , Bruno P Mmbando  5
Affiliations
Randomized Controlled Trial

Dihydroartemisinin-piperaquine effectiveness for seasonal malaria chemoprevention in settings with extended seasonal malaria transmission in Tanzania

Richard Mwaiswelo et al. Sci Rep. .

Abstract

Effectiveness of dihydroartemisinin-piperaquine (DP) as seasonal malaria chemoprevention (SMC) was assessed in Nanyumbu and Masasi Districts. Between March and June 2021, children aged 3-59 months were enrolled in a cluster randomized study. Children in the intervention clusters received a monthly, 3-days course of DP for three consecutive months regardless of malaria infection status, and those in the control clusters received no intervention. Malaria infection was assessed at before the first-round and at 7 weeks after the third-round of DP in both arms. Malaria prevalence after the third-round of DP administration was the primary outcome. Chi-square tests and logistic regression model were used to compare proportions and adjust for explanatory variables. Before the intervention, malaria prevalence was 13.7% (161/1171) and 18.2% (212/1169) in the intervention and control clusters, respectively, p < 004. Malaria prevalence declined to 5.8% (60/1036) in the intervention clusters after three rounds of DP, and in the control clusters it declined to 9.3% (97/1048), p = 0.003. Unadjusted and adjusted prevalence ratios between the intervention and control arms were 0.42 (95%CI 0.32-0.55, p < 0.001) and 0.77 (95%CI 0.53-1.13, p = 0.189), respectively. SMC using DP was effective for control of malaria in the two Districts.Trial registration: NCT05874869, https://clinicaltrials.gov/ 25/05/2023.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Trial profile showing study population screening for malaria using mRDT tests, test results (mRDT positive (+ve) and negative (−ve)) and population that received study drug (DP) at the three time points.
Figure 2
Figure 2
Distribution of mRDT positivity by age group. The top panels show the prevalence in the control and intervention groups before and after deployment of DP in Masasi (A) and Nanyumbu (B) Districts. Panels C (Masasi) and D (Nanyumbu) shows the prevalence of mRDT positive in 2021 by study group (control vs. intervention).
Figure 3
Figure 3
Overall and District specific distribution of anemia by age groups.
Figure 4
Figure 4
Weather characteristics of Nanyumbu and Masasi Districts.
See this image and copyright information in PMC

References

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    1. WHO. World Malaria Report 2015. World Health Organization, Geneva, Switzerland. https://apps.who.int/iris/handle/10665/200018 (2015).
    1. WHO. World Malaria Report 2017. World Health Organization, Geneva, Switzerland. https://www.who.int/publications/i/item/9789241565523 (2017).
    1. WHO. World Malaria Report 2010. World Health Organization, Geneva, Switzerland. https://apps.who.int/iris/handle/10665/44451 (2010).
    1. WHO. Intermittent Preventive Treatment of malaria in pregnancy using Sulfadoxine- Pyrimethamine (IPTp-SP). World Health Organization, Geneva, Switzerland. https://www.who.int/publications/i/item/WHO-HTM-GMP-2014.4 (2012).

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