Malaria trends in districts that were targeted and not-targeted for seasonal malaria chemoprevention in children under 5 years of age in Guinea, 2014–2021
BackgroundSeasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting children aged 3–59 months (CU5) in districts with high and seasonal malaria transmission.ObjectiveWe assessed the programmatic impact of S...
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| Published in | BMJ global health Vol. 9; no. 2; p. e013898 |
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| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
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England
BMJ Publishing Group Ltd
26.02.2024
BMJ Publishing Group LTD BMJ Publishing Group |
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| Abstract | BackgroundSeasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting children aged 3–59 months (CU5) in districts with high and seasonal malaria transmission.ObjectiveWe assessed the programmatic impact of SMC in Guinea’s context of scaled up malaria intervention programming by comparing malaria-related outcomes in 14 districts that had or had not been targeted for SMC.MethodsUsing routine health management information system data, we compared the district-level monthly test positivity rate (TPR) and monthly uncomplicated and severe malaria incidence for the whole population and disaggregated age groups (<5 years and ≥5 years of age). Changes in malaria indicators through time were analysed by calculating the district-level compound annual growth rate (CAGR) from 2014 to 2021; we used statistical analyses to describe trends in tested clinical cases, TPR, uncomplicated malaria incidence and severe malaria incidence.ResultsThe CAGR of TPR of all age groups was statistically lower in SMC (median=−7.8%) compared with non-SMC (median=−3.0%) districts. Similarly, the CAGR in uncomplicated malaria incidence was significantly lower in SMC (median=1.8%) compared with non-SMC (median=11.5%) districts. For both TPR and uncomplicated malaria incidence, the observed difference was also significant when age disaggregated. The CAGR of severe malaria incidence showed that all age groups experienced a decline in severe malaria in both SMC and non-SMC districts. However, this decline was significantly higher in SMC (median=−22.3%) than in non-SMC (median=−5.1%) districts for the entire population, as well as both CU5 and people over 5 years of age.ConclusionEven in an operational programming context, adding SMC to the malaria intervention package yields a positive epidemiological impact and results in a greater reduction in TPR, as well as the incidence of uncomplicated and severe malaria in CU5. |
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| AbstractList | Seasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting children aged 3-59 months (CU5) in districts with high and seasonal malaria transmission.
We assessed the programmatic impact of SMC in Guinea's context of scaled up malaria intervention programming by comparing malaria-related outcomes in 14 districts that had or had not been targeted for SMC.
Using routine health management information system data, we compared the district-level monthly test positivity rate (TPR) and monthly uncomplicated and severe malaria incidence for the whole population and disaggregated age groups (<5 years and ≥5 years of age). Changes in malaria indicators through time were analysed by calculating the district-level compound annual growth rate (CAGR) from 2014 to 2021; we used statistical analyses to describe trends in tested clinical cases, TPR, uncomplicated malaria incidence and severe malaria incidence.
The CAGR of TPR of all age groups was statistically lower in SMC (median=-7.8%) compared with non-SMC (median=-3.0%) districts. Similarly, the CAGR in uncomplicated malaria incidence was significantly lower in SMC (median=1.8%) compared with non-SMC (median=11.5%) districts. For both TPR and uncomplicated malaria incidence, the observed difference was also significant when age disaggregated. The CAGR of severe malaria incidence showed that all age groups experienced a decline in severe malaria in both SMC and non-SMC districts. However, this decline was significantly higher in SMC (median=-22.3%) than in non-SMC (median=-5.1%) districts for the entire population, as well as both CU5 and people over 5 years of age.
Even in an operational programming context, adding SMC to the malaria intervention package yields a positive epidemiological impact and results in a greater reduction in TPR, as well as the incidence of uncomplicated and severe malaria in CU5. BACKGROUNDSeasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting children aged 3-59 months (CU5) in districts with high and seasonal malaria transmission.OBJECTIVEWe assessed the programmatic impact of SMC in Guinea's context of scaled up malaria intervention programming by comparing malaria-related outcomes in 14 districts that had or had not been targeted for SMC.METHODSUsing routine health management information system data, we compared the district-level monthly test positivity rate (TPR) and monthly uncomplicated and severe malaria incidence for the whole population and disaggregated age groups (<5 years and ≥5 years of age). Changes in malaria indicators through time were analysed by calculating the district-level compound annual growth rate (CAGR) from 2014 to 2021; we used statistical analyses to describe trends in tested clinical cases, TPR, uncomplicated malaria incidence and severe malaria incidence.RESULTSThe CAGR of TPR of all age groups was statistically lower in SMC (median=-7.8%) compared with non-SMC (median=-3.0%) districts. Similarly, the CAGR in uncomplicated malaria incidence was significantly lower in SMC (median=1.8%) compared with non-SMC (median=11.5%) districts. For both TPR and uncomplicated malaria incidence, the observed difference was also significant when age disaggregated. The CAGR of severe malaria incidence showed that all age groups experienced a decline in severe malaria in both SMC and non-SMC districts. However, this decline was significantly higher in SMC (median=-22.3%) than in non-SMC (median=-5.1%) districts for the entire population, as well as both CU5 and people over 5 years of age.CONCLUSIONEven in an operational programming context, adding SMC to the malaria intervention package yields a positive epidemiological impact and results in a greater reduction in TPR, as well as the incidence of uncomplicated and severe malaria in CU5. BackgroundSeasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting children aged 3–59 months (CU5) in districts with high and seasonal malaria transmission.ObjectiveWe assessed the programmatic impact of SMC in Guinea’s context of scaled up malaria intervention programming by comparing malaria-related outcomes in 14 districts that had or had not been targeted for SMC.MethodsUsing routine health management information system data, we compared the district-level monthly test positivity rate (TPR) and monthly uncomplicated and severe malaria incidence for the whole population and disaggregated age groups (<5 years and ≥5 years of age). Changes in malaria indicators through time were analysed by calculating the district-level compound annual growth rate (CAGR) from 2014 to 2021; we used statistical analyses to describe trends in tested clinical cases, TPR, uncomplicated malaria incidence and severe malaria incidence.ResultsThe CAGR of TPR of all age groups was statistically lower in SMC (median=−7.8%) compared with non-SMC (median=−3.0%) districts. Similarly, the CAGR in uncomplicated malaria incidence was significantly lower in SMC (median=1.8%) compared with non-SMC (median=11.5%) districts. For both TPR and uncomplicated malaria incidence, the observed difference was also significant when age disaggregated. The CAGR of severe malaria incidence showed that all age groups experienced a decline in severe malaria in both SMC and non-SMC districts. However, this decline was significantly higher in SMC (median=−22.3%) than in non-SMC (median=−5.1%) districts for the entire population, as well as both CU5 and people over 5 years of age.ConclusionEven in an operational programming context, adding SMC to the malaria intervention package yields a positive epidemiological impact and results in a greater reduction in TPR, as well as the incidence of uncomplicated and severe malaria in CU5. Background Seasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting children aged 3–59 months (CU5) in districts with high and seasonal malaria transmission.Objective We assessed the programmatic impact of SMC in Guinea’s context of scaled up malaria intervention programming by comparing malaria-related outcomes in 14 districts that had or had not been targeted for SMC.Methods Using routine health management information system data, we compared the district-level monthly test positivity rate (TPR) and monthly uncomplicated and severe malaria incidence for the whole population and disaggregated age groups (<5 years and ≥5 years of age). Changes in malaria indicators through time were analysed by calculating the district-level compound annual growth rate (CAGR) from 2014 to 2021; we used statistical analyses to describe trends in tested clinical cases, TPR, uncomplicated malaria incidence and severe malaria incidence.Results The CAGR of TPR of all age groups was statistically lower in SMC (median=−7.8%) compared with non-SMC (median=−3.0%) districts. Similarly, the CAGR in uncomplicated malaria incidence was significantly lower in SMC (median=1.8%) compared with non-SMC (median=11.5%) districts. For both TPR and uncomplicated malaria incidence, the observed difference was also significant when age disaggregated. The CAGR of severe malaria incidence showed that all age groups experienced a decline in severe malaria in both SMC and non-SMC districts. However, this decline was significantly higher in SMC (median=−22.3%) than in non-SMC (median=−5.1%) districts for the entire population, as well as both CU5 and people over 5 years of age.Conclusion Even in an operational programming context, adding SMC to the malaria intervention package yields a positive epidemiological impact and results in a greater reduction in TPR, as well as the incidence of uncomplicated and severe malaria in CU5. Background Seasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting children aged 3–59 months (CU5) in districts with high and seasonal malaria transmission. Objective We assessed the programmatic impact of SMC in Guinea’s context of scaled up malaria intervention programming by comparing malaria-related outcomes in 14 districts that had or had not been targeted for SMC. Methods Using routine health management information system data, we compared the district-level monthly test positivity rate (TPR) and monthly uncomplicated and severe malaria incidence for the whole population and disaggregated age groups (<5 years and ≥5 years of age). Changes in malaria indicators through time were analysed by calculating the district-level compound annual growth rate (CAGR) from 2014 to 2021; we used statistical analyses to describe trends in tested clinical cases, TPR, uncomplicated malaria incidence and severe malaria incidence. Results The CAGR of TPR of all age groups was statistically lower in SMC (median=−7.8%) compared with non-SMC (median=−3.0%) districts. Similarly, the CAGR in uncomplicated malaria incidence was significantly lower in SMC (median=1.8%) compared with non-SMC (median=11.5%) districts. For both TPR and uncomplicated malaria incidence, the observed difference was also significant when age disaggregated. The CAGR of severe malaria incidence showed that all age groups experienced a decline in severe malaria in both SMC and non-SMC districts. However, this decline was significantly higher in SMC (median=−22.3%) than in non-SMC (median=−5.1%) districts for the entire population, as well as both CU5 and people over 5 years of age. Conclusion Even in an operational programming context, adding SMC to the malaria intervention package yields a positive epidemiological impact and results in a greater reduction in TPR, as well as the incidence of uncomplicated and severe malaria in CU5. |
| Author | Fofana, Aissata Camara, Alioune Preston, Adam Bangoura, Lamine Reithinger, Richard Diallo, Thierno Guilavogui, Timothée Mbounga, Eliane Florey, Lia S Taton, Jean-Luc Barry, Hamidou Keita, Mamadou Sitan Bisanzio, Donal |
| AuthorAffiliation | 3 Programme National de la Lutte contre le Paludisme , Ministère de la Santé et de l'Hygiène Publique , Conakry , Guinea 2 RTI International , Conakry , Guinea 4 Ministère de la Santé et de l'Hygiène Publique , Conakry , Guinea 7 US Agency for International Development , Washington , District of Columbia , USA 5 RTI International , Fort Collins , Colorado , USA 1 RTI International , Washington , District of Columbia , USA 6 President's Malaria Initiative , US Agency for International Development , Conakry , Guinea |
| AuthorAffiliation_xml | – name: 4 Ministère de la Santé et de l'Hygiène Publique , Conakry , Guinea – name: 3 Programme National de la Lutte contre le Paludisme , Ministère de la Santé et de l'Hygiène Publique , Conakry , Guinea – name: 7 US Agency for International Development , Washington , District of Columbia , USA – name: 1 RTI International , Washington , District of Columbia , USA – name: 2 RTI International , Conakry , Guinea – name: 5 RTI International , Fort Collins , Colorado , USA – name: 6 President's Malaria Initiative , US Agency for International Development , Conakry , Guinea |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38413098$$D View this record in MEDLINE/PubMed |
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2024051502191962000_9.2.e013898.18 article-title: Coverage, adherence and costs of intermittent preventive treatment of malaria in children employing different delivery strategies in Jasikan, Ghana publication-title: PLoS One doi: 10.1371/journal.pone.0024871 contributor: fullname: Patouillard – ident: 2024051502191962000_9.2.e013898.43 doi: 10.1001/jama.2013.281425 – ident: 2024051502191962000_9.2.e013898.8 – volume: 11 year: 2022 ident: 2024051502191962000_9.2.e013898.45 article-title: Feasibility, acceptability, and protective efficacy of seasonal malaria chemoprevention implementation in Nampula province, Mozambique: protocol for a hybrid effectiveness-implementation study publication-title: JMIR Res Protoc doi: 10.2196/36403 contributor: fullname: Baker – volume: 16 start-page: 325 year: 2017 ident: 2024051502191962000_9.2.e013898.12 article-title: Measuring the impact of seasonal malaria chemoprevention as part of routine malaria control in Kita, Mali publication-title: Malar J doi: 10.1186/s12936-017-1974-x contributor: fullname: Diawara – volume: 8 year: 2011 ident: 2024051502191962000_9.2.e013898.19 article-title: Two strategies for the delivery of IPTc in an area of seasonal malaria transmission in the Gambia: a randomised controlled trial publication-title: PLoS Med doi: 10.1371/journal.pmed.1000409 contributor: fullname: Bojang – ident: 2024051502191962000_9.2.e013898.36 doi: 10.1093/heapol/czv029 – volume: 38 start-page: 673 year: 2022 ident: 2024051502191962000_9.2.e013898.38 article-title: Pharmacokinetic considerations in seasonal malaria chemoprevention publication-title: Trends Parasitol doi: 10.1016/j.pt.2022.05.003 contributor: fullname: Chotsiri – volume: 22 year: 2023 ident: 2024051502191962000_9.2.e013898.44 article-title: A non-randomized controlled trial to assess the protective effect of SMC in the context of high parasite resistance in Uganda publication-title: Malar J doi: 10.1186/s12936-023-04488-4 contributor: fullname: Nuwa – volume: 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| Snippet | BackgroundSeasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC... Seasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC targeting... Background Seasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC... BACKGROUNDSeasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC... Background Seasonal malaria chemoprevention (SMC) is a main intervention to prevent and reduce childhood malaria. Since 2015, Guinea has implemented SMC... |
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| SubjectTerms | Age Caregivers Control strategies Disease transmission Drug dosages Epidemics Health facilities Intervention Malaria Management information systems Mortality Nurses Original Research Prevention strategies Public Health Software Statistical analysis Vector-borne diseases |
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| Title | Malaria trends in districts that were targeted and not-targeted for seasonal malaria chemoprevention in children under 5 years of age in Guinea, 2014–2021 |
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