Assessing the effect of seasonal malaria chemoprevention on malaria burden among children under 5 years in Burkina Faso

评估季节性疟疾化学预防对布基纳法索5岁以下儿童疟疾负担的影响

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Abstract

BACKGROUND: In 2014, the Burkina Faso government launched the Seasonal Malaria Chemoprevention (SMC) programme. Expected benefit was a 75% reduction of all malaria episodes and a 75% drop of severe malaria episodes. This study assessed SMC efficiency on malaria morbidity in the country after 2 years of implementation. METHODS: Quasi-experimental design comparing changes in outcomes during the high transmission period (August-November) between SMC and non-SMC health districts before (2013-2014) and after intervention (two rounds in 2015 and 2016). Health indicators (number of uncomplicated malaria cases (UM) and severe malaria cases (SM)) from 19 health districts (8 in intervention and 11 in comparison group) were extracted from the District Health Information System (DHIS2)-based platform including health facilities data. Effect on incidence was assessed by fitting difference-in difference mixed-effects negative binomial regression model at a log scale. RESULTS: The two rounds of SMC were associated with a reduction of UM incidence (ratio of incidence rate ratio (IRR) 69% (95% CI 55-86%); p = 0.001) and SM incidence (ratio of IRR = 73% (55-95%), p = 0.018) among under five children. CONCLUSION: The two rounds of SMC had a significant effect on the reduction of malaria cases in under five children. This additional evidence on the effectiveness of SMC, using routine data, support the need to sustain its implementation and consider expansion to eligible areas not yet covered.

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