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

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, Richard Idro, Daniel J. Weiss, Matthew Cairns, Feiko O. ter Kuile, Kamija Phiri, Bjarne Robberstad, Amani Thomas Mori

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

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.

Original languageEnglish
Article number402
JournalNature Communications
Volume14
Issue number1
DOIs
Publication statusPublished - Dec 2023
Externally publishedYes

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