Projected health impact of post-discharge malaria chemoprevention among children with severe malarial anaemia in Africa.


Journal

Nature communications
ISSN: 2041-1723
Titre abrégé: Nat Commun
Pays: England
ID NLM: 101528555

Informations de publication

Date de publication:
25 01 2023
Historique:
received: 14 04 2022
accepted: 09 01 2023
entrez: 25 1 2023
pubmed: 26 1 2023
medline: 28 1 2023
Statut: epublish

Résumé

Children recovering from severe malarial anaemia (SMA) remain at high risk of readmission and death after discharge from hospital. However, a recent trial found that post-discharge malaria chemoprevention (PDMC) with dihydroartemisinin-piperaquine reduces this risk. We developed a mathematical model describing the daily incidence of uncomplicated and severe malaria requiring readmission among 0-5-year old children after hospitalised SMA. We fitted the model to a multicentre clinical PDMC trial using Bayesian methods and modelled the potential impact of PDMC across malaria-endemic African countries. In the 20 highest-burden countries, we estimate that only 2-5 children need to be given PDMC to prevent one hospitalised malaria episode, and less than 100 to prevent one death. If all hospitalised SMA cases access PDMC in moderate-to-high transmission areas, 38,600 (range 16,900-88,400) malaria-associated readmissions could be prevented annually, depending on access to hospital care. We estimate that recurrent SMA post-discharge constitutes 19% of all SMA episodes in moderate-to-high transmission settings.

Identifiants

pubmed: 36697413
doi: 10.1038/s41467-023-35939-w
pii: 10.1038/s41467-023-35939-w
pmc: PMC9876927
doi:

Substances chimiques

Antimalarials 0
Drug Combinations 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

402

Subventions

Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Medical Research Council
Pays : United Kingdom

Informations de copyright

© 2023. The Author(s).

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Auteurs

Lucy C Okell (LC)

MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, W2 1PG, UK. l.okell@imperial.ac.uk.

Titus K Kwambai (TK)

Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
Department of Clinical Sciences, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK.

Aggrey Dhabangi (A)

College of Health Sciences, Makerere University, Kampala, Uganda.

Carole Khairallah (C)

Department of Clinical Sciences, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK.

Thandile Nkosi-Gondwe (T)

Kamuzu University of Health Sciences, Blantyre, Malawi.
Training and Research Unit of Excellence, Blantyre, Malawi.

Peter Winskill (P)

MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, W2 1PG, UK.

Robert Opoka (R)

College of Health Sciences, Makerere University, Kampala, Uganda.

Andria Mousa (A)

MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, W2 1PG, UK.

Melf-Jakob Kühl (MJ)

Section for Ethics and Health Economics, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway.

Tim C D Lucas (TCD)

Big Data Institute, University of Oxford, Oxford, UK.

Joseph D Challenger (JD)

MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College, London, W2 1PG, UK.

Richard Idro (R)

College of Health Sciences, Makerere University, Kampala, Uganda.

Daniel J Weiss (DJ)

Malaria Atlas Project, Telethon Kids Institute, Perth Children's Hospital, 15 Hospital Avenue, Nedlands, Australia.
Curtin University, Bentley, Australia.

Matthew Cairns (M)

International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.

Feiko O Ter Kuile (FO)

Centre for Global Health Research (CGHR), Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.
Department of Clinical Sciences, Liverpool School of Tropical Medicine (LSTM), Liverpool, UK.

Kamija Phiri (K)

Kamuzu University of Health Sciences, Blantyre, Malawi.
Training and Research Unit of Excellence, Blantyre, Malawi.

Bjarne Robberstad (B)

Section for Ethics and Health Economics, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway.

Amani Thomas Mori (AT)

Section for Ethics and Health Economics, Department of Global Public Health and Primary Care, University of Bergen, P.O. Box 7804, 5020, Bergen, Norway. pax_amani@yahoo.com.
Chr. Michelsen Institute, P.O. Box 6033, N-5892, Bergen, Norway. pax_amani@yahoo.com.
Muhimbili University of Health and Allied Sciences, P.O.Box 65001, Dar es Salaam, Tanzania. pax_amani@yahoo.com.

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