Effectiveness and Community Acceptance of Extending Seasonal Malaria Chemoprevention to Children 5 to 14 Years of Age in Dangassa, Mali

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  • 1 West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;
  • | 2 University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali;
  • | 3 School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana

Seasonal malaria chemoprevention (SMC) was adopted in Mali in 2012 for preventing malaria in children younger than 5 years. Although this strategy has been highly effective in reducing childhood malaria, an uptick in malaria occurrence has occurred in children 5 to 15 years of age. This study aimed to investigate the feasibility of providing SMC to older children. A cohort of 350 children age 5 to 14 years were monitored during the 2019 transmission season in Dangassa, Mali. The intervention group received five monthly rounds of sulfadoxine–pyrimethamine plus amodiaquine, whereas the control group consisted of untreated children. Community acceptance for extending SMC was assessed during the final round. Logistic regression models were applied to compare the risk of Plasmodium falciparum malaria infection, anemia, and fever between the intervention and control groups. Kaplan-Meier survival analyses were used to compare the time to P. falciparum parasitemia infection between the groups. The community acceptance rate was 96.5% (139 of 144). Significant declines were observed in the prevalence of P. falciparum parasitemia (adjusted odds ratio, 0.22; 95% CI, 0.11–0.42) and anemia (adjusted odds ratio, 0.15; 95% CI, 0.07–0.28) in the intervention group compared with the control group. The cumulative incidence of P. falciparum infections was significantly greater (75.4%, 104 of 138) in the control group compared with the intervention group (40.7%, 61 of 143, P = 0.001). This study reveals that expanding SMC to older children is likely feasible, has high community acceptance, and is in reducing uncomplicated malaria and anemia in older children.

Author Notes

Address correspondence to Drissa Konaté, FMOS, Point-G, BP 1805, Bamako, Mali. E-mail: dkonate@icermali.org

Financial support: This study was supported by the National Institutes of Health Cooperative Agreements U2RTW010673 for the West African Center of Excellence for Global Health Bioinformatics Research Training, and U19AI089696 and U19AI129387 for the West African Center of Excellence for Malaria Research. D. K. received support from the Fogarty International Center of the U.S. National Institutes of Health of the under grant no. D43TW008652.

Authors’ addresses: Drissa Konaté, Sory Ibrahim Diawara, Bourama Keita, Nafomon Sogoba, Mahamadou Fayiçal, Agnès Guindo, and Sibe Thiam, West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali, E-mails: dkonate@icermali.org, sdiawara@icermali.org, bouramakeita@icermali.org, nafomon@icermali.org, fayicalmahamadou1@gmail.com, agnes@icermali.org, and sibe_t@icermali.org. Sékou Fantamady Traoré, Seydou Doumbia, and Mahamadou Diakité, West African International Center for Excellence in Malaria Research, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali, and University Clinical Research Center, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali, E-mails: check@icermali.org, sdoumbi@icermali.org, and mdiakite@icermali.org. Jeffrey G. Shaffer, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, E-mail: jshaffer@tulane.edu.

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