Abstract
BackgroundPlasmodium falciparum malaria remains a major public health concern in sub-Sahara Africa. Seasonal malaria chemoprevention (SMC) with amodiaquine + sulfadoxine-pyrimethamine is one of the most important preventive interventions. Despite its implementation, the burden of malaria is still very high in children under five years old in Burkina Faso, suggesting that the expected impact of this promising strategy might not be attained. Development of innovative strategies to improve the efficacy of these existing malaria control measures is essential. In such context, we postulate that screening and treatment of malaria in household members of children receiving SMC could greatly improve the impact of SMC intervention and reduce malaria transmission in endemic settings.MethodsThis randomized superiority trial will be carried out in the Nanoro health district, Burkina Faso. The unit of randomisation will be the household and all eligible children from a household will be allocated to the same study group. Households with 3–59 months old children will be assigned to either (i) control group (SMC alone) or (ii) intervention (SMC+ screening of household members with standard Histidin Rich Protein Rapid Diagnostic Test (HRP2-RDT) and treatment if positive). The sample size will be 526 isolated households per arm, i.e., around 1052 children under SMC coverage and an expected 1315 household members. Included children will be followed-up for 24 months to fully cover two consecutive malaria transmission seasons and two SMC cycles. Children will be actively followed-up during the malaria transmission seasons while in the dry seasons the follow-up will be passive.ConclusionThe study will respond to a major public health concern by providing evidence of the efficacy of an innovative strategy to boost the impact of SMC intervention.
Highlights
Plasmodium falciparum malaria remains a major public health concern in sub-Sahara Africa
The study will respond to a major public health concern by providing evidence of the efficacy of an innovative strategy to boost the impact of Seasonal malaria chemoprevention (SMC) intervention
To reduce the burden of the disease in the country, Burkina Faso has subscribed to the Roll Back Malaria initiative and adopted several malaria control measures including the use of artemisinin-based combination therapies (ACTs) as first line treatment since 2005, intermittent preventive treatment in pregnancy (IPTp), wide-scale distribution of long-lasting insecticide treated nets, and seasonal malaria chemoprevention (SMC) for children younger than five years [2]
Summary
Plasmodium falciparum malaria remains a major public health concern in sub-Sahara Africa. Development of innovative strategies to improve the efficacy of these existing malaria control measures is essential In such context, we postulate that screening and treatment of malaria in household members of children receiving SMC could greatly improve the impact of SMC intervention and reduce malaria transmission in endemic settings. To reduce the burden of the disease in the country, Burkina Faso has subscribed to the Roll Back Malaria initiative and adopted several malaria control measures including the use of artemisinin-based combination therapies (ACTs) as first line treatment since 2005, intermittent preventive treatment in pregnancy (IPTp), wide-scale distribution of long-lasting insecticide treated nets, and seasonal malaria chemoprevention (SMC) for children younger than five years [2]. In 2019, over 10 million clinical episodes and 1060 deaths were reported in the country [1]
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