Abstract
Malaria disproportionately affects all ages with a high burden among children below five years. Thus, control measures are deployed including Seasonal Malaria Chemoprevention (SMC). The present study assessed the impacts of SMC on malaria burden among subjects aged 3–59 months in Borno State, Nigeria. Twenty (20) clusters were randomly selected from accessible 16 Local Government Areas (LGAs) of Borno State, Nigeria, and SMC was deployed in 10 of the clusters by administering a full dose of amodiaquine plus sulfadoxine-pyrimethamine at monthly intervals for 4 months consecutively. Three hundred and ninety-nine children were enrolled in the study. A structured questionnaire was used to obtain demographic and malaria-related data. Thick blood smear, thin blood smear, and capillary sample were collected two weeks after the 4th cycle of SMC. The prevalence of malaria and anaemia was determined among the subjects and for the clusters. The proportions of the female (46.4%; 185/399) and male (53.6%; 214/399) subjects were similar (p > 0.05) with subjects aged 24–47 months (35.8%; 143/399) accounting for the highest proportion (p < 0.05). Malaria prevalence was 10.3% (41/399) and was higher among non-SMC subjects (15.9%; 31/195) than among SMC subjects (4.9%; 10/204) (p < 0.05, df = 1, χ2 = 10.8). Malaria prevalence was higher in non-SMC clusters (80.0%; 8/10) than in SMC clusters (30.0%; 3/10) (p < 0.05, df = 1, χ2 = 40.5). The mean haematocrit of the 399 subjects was 34.0 ± 5.3% with an anaemia prevalence of 18.1% (72/399). The mean haematocrit was higher among SMC subjects (35.4 ± 5.0% vs. 33.1 ± 4.2%; p < 0.05) while anaemia prevalence was higher among non-SMC subjects (21.5% vs. 14.6%; p < 0.05, df = 1, χ2 = 2.8). Of the SMC subjects, 4.9% reported adverse drug reactions. SMC is safe and significantly reduced malaria burden among children in Borno State, and thus, the measure could be deployed in the state for effective malaria control.
Highlights
Malaria is a febrile protozoan infection of global public health concern with most burden experience in sub-Saharan Africa and Southeast Asia where the disease is endemic
Seasonal Malaria Chemoprevention (SMC) is the complete treatment course with a fixed-dose combination of amodiaquine and sulfadoxine-pyrimethamine given at monthly intervals to children aged 3–59 months, beginning at the start of the transmission season [7, 8]. e SMC is recommended for the prevention of falciparum malaria in high seasonal transmission areas of sub-Saharan Africa. e delivery of the medication is primarily door-to-door in most countries and this has significantly improved coverage areas
The population distribution of the state has been significantly distorted with over 2 million internally displaced persons (IDPs) due to the protracted armed conflict in the region. e health facilities are overstretched due to the overwhelming number of IDPs in most accessible towns in the state. e crisis in the region has complicated the burden of malaria and other health conditions that prompted governments and nongovernmental organizations to provide number of intervention programmes [11]. us, the present study assessed the impacts of SMC on malaria burden among subjects aged 3–59 months in Borno State, Nigeria
Summary
Malaria is a febrile protozoan infection of global public health concern with most burden experience in sub-Saharan Africa and Southeast Asia where the disease is endemic. All the 15 countries except India are in sub-Saharan Africa, and Nigeria ranked as one of the high malaria burdened countries [3]. E SMC is recommended for the prevention of falciparum malaria in high seasonal transmission areas of sub-Saharan Africa. Nigeria is one of the beneficiaries of the SMC scaled-up programme with 6.3 million doses of the drugs administered to children across the states between 2012 and 2016 [3]. E crisis in the region has complicated the burden of malaria and other health conditions that prompted governments and nongovernmental organizations to provide number of intervention programmes [11]. The population distribution of the state has been significantly distorted with over 2 million internally displaced persons (IDPs) due to the protracted armed conflict in the region. e health facilities are overstretched due to the overwhelming number of IDPs in most accessible towns in the state. e crisis in the region has complicated the burden of malaria and other health conditions that prompted governments and nongovernmental organizations to provide number of intervention programmes [11]. us, the present study assessed the impacts of SMC on malaria burden among subjects aged 3–59 months in Borno State, Nigeria
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