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

Author

Listed:
  • Lucy C. Okell

    (Imperial College)

  • Titus K. Kwambai

    (Kenya Medical Research Institute (KEMRI)
    Liverpool School of Tropical Medicine (LSTM))

  • Aggrey Dhabangi

    (Makerere University)

  • Carole Khairallah

    (Liverpool School of Tropical Medicine (LSTM))

  • Thandile Nkosi-Gondwe

    (Kamuzu University of Health Sciences
    Training and Research Unit of Excellence)

  • Peter Winskill

    (Imperial College)

  • Robert Opoka

    (Makerere University)

  • Andria Mousa

    (Imperial College)

  • Melf-Jakob Kühl

    (University of Bergen)

  • Tim C. D. Lucas

    (University of Oxford)

  • Joseph D. Challenger

    (Imperial College)

  • Richard Idro

    (Makerere University)

  • Daniel J. Weiss

    (Telethon Kids Institute, Perth Children’s Hospital
    Curtin University)

  • Matthew Cairns

    (London School of Hygiene and Tropical Medicine)

  • Feiko O. Kuile

    (Kenya Medical Research Institute (KEMRI)
    Liverpool School of Tropical Medicine (LSTM))

  • Kamija Phiri

    (Kamuzu University of Health Sciences
    Training and Research Unit of Excellence)

  • Bjarne Robberstad

    (University of Bergen)

  • Amani Thomas Mori

    (University of Bergen
    Chr. Michelsen Institute
    Muhimbili University of Health and Allied Sciences)

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.

Suggested Citation

  • Lucy C. Okell & Titus K. Kwambai & Aggrey Dhabangi & Carole Khairallah & Thandile Nkosi-Gondwe & Peter Winskill & Robert Opoka & Andria Mousa & Melf-Jakob Kühl & Tim C. D. Lucas & Joseph D. Challenger, 2023. "Projected health impact of post-discharge malaria chemoprevention among children with severe malarial anaemia in Africa," Nature Communications, Nature, vol. 14(1), pages 1-10, December.
  • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-35939-w
    DOI: 10.1038/s41467-023-35939-w
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    References listed on IDEAS

    as
    1. Lucy C. Okell & Matthew Cairns & Jamie T. Griffin & Neil M. Ferguson & Joel Tarning & George Jagoe & Pierre Hugo & Mark Baker & Umberto D’Alessandro & Teun Bousema & David Ubben & Azra C. Ghani, 2014. "Contrasting benefits of different artemisinin combination therapies as first-line malaria treatments using model-based cost-effectiveness analysis," Nature Communications, Nature, vol. 5(1), pages 1-11, December.
    2. Jamie T. Griffin & Neil M. Ferguson & Azra C. Ghani, 2014. "Estimates of the changing age-burden of Plasmodium falciparum malaria disease in sub-Saharan Africa," Nature Communications, Nature, vol. 5(1), pages 1-10, May.
    3. Conteh, Lesong & Shuford, Kathryn & Agboraw, Efundem & Kont, Mara & Kolaczinski, Jan & Patouillard, Edith, 2021. "Costs and cost-effectiveness of Malaria control interventions: a systematic literature review," LSE Research Online Documents on Economics 112779, London School of Economics and Political Science, LSE Library.
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