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

Okell, Lucy C., Kwambai, Titus, Dhabangi, Aggrey, Khairallah, Carole, Nkosi-Gondwe, Thandile, Winskill, Peter, Opoka, Robert, Mousa, Andria, Kühl, Melf-Jakob, Lucas, Tim C. D., Challenger, Joseph D., Idro, Richard, Weiss, Daniel J., Cairns, Matthew, terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617, Phiri, Kamija, Robberstad, Bjarne and Mori, Amani Thomas (2023) 'Projected health impact of post-discharge malaria chemoprevention among children with severe malarial anaemia in Africa'. Nature Communications, Vol 14, Issue 1, e402.

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Abstract

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.

Item Type:	Article
Subjects:	WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases WA Public Health > WA 30 Socioeconomic factors in public health (General) WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WH Hemic and Lymphatic Systems > Hematologic Diseases. Immunologic Factors. Blood Banks > WH 155 Anemia WS Pediatrics > WS 20 Research (General)
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1038/s41467-023-35939-w
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	08 Feb 2023 15:21
Last Modified:	08 Feb 2023 15:21
URI:	https://archive.lstmed.ac.uk/id/eprint/21839

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