Evaluation of direct and indirect effects of seasonal malaria chemoprevention in Mali

Abstract Randomized controlled trials have established that seasonal malaria chemoprevention (SMC) in children is a promising strategy to reduce malaria transmission in Sahelian West Africa. This strategy was recently introduced in a dozen countries, and about 12 million children received SMC in 201...

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Autor principal:	Thomas Druetz
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2018
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/12f9e69ed0b14ff1bbd03057533c5819
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spelling	oai:doaj.org-article:12f9e69ed0b14ff1bbd03057533c58192021-12-02T15:08:35ZEvaluation of direct and indirect effects of seasonal malaria chemoprevention in Mali10.1038/s41598-018-26474-62045-2322https://doaj.org/article/12f9e69ed0b14ff1bbd03057533c58192018-05-01T00:00:00Zhttps://doi.org/10.1038/s41598-018-26474-6https://doaj.org/toc/2045-2322Abstract Randomized controlled trials have established that seasonal malaria chemoprevention (SMC) in children is a promising strategy to reduce malaria transmission in Sahelian West Africa. This strategy was recently introduced in a dozen countries, and about 12 million children received SMC in 2016. However, evidence on SMC effectiveness under routine programme conditions is sparse. We aim to measure the effects of the nationwide SMC programme in Mali on the prevalence of malaria and anemia in children 6–59 months. We used data from the 2015 nationally representative malaria indicator survey. A post-test only with non-randomized control group study was designed. We fitted a generalized structural equation model that controlled for potential bias on observed and non-observed variables (endogenous treatment effect model). Having received SMC reduced by 44% (95% CI [0.39–0.49]) the risk of having a positive rapid diagnostic test for malaria. In addition, the programme indirectly reduced by 18% the risk of moderate-to-severe anemia (95% CI [0.15–0.21]). SMC in Mali has substantial protective effects under routine nationwide programme conditions. Endogenous treatment effects analyses can contribute to rigorously measuring the effectiveness of health programmes and to bridging a widening gap in evaluation methods to measure progress towards achieving malaria elimination.Thomas DruetzNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 8, Iss 1, Pp 1-9 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thomas Druetz Evaluation of direct and indirect effects of seasonal malaria chemoprevention in Mali
description	Abstract Randomized controlled trials have established that seasonal malaria chemoprevention (SMC) in children is a promising strategy to reduce malaria transmission in Sahelian West Africa. This strategy was recently introduced in a dozen countries, and about 12 million children received SMC in 2016. However, evidence on SMC effectiveness under routine programme conditions is sparse. We aim to measure the effects of the nationwide SMC programme in Mali on the prevalence of malaria and anemia in children 6–59 months. We used data from the 2015 nationally representative malaria indicator survey. A post-test only with non-randomized control group study was designed. We fitted a generalized structural equation model that controlled for potential bias on observed and non-observed variables (endogenous treatment effect model). Having received SMC reduced by 44% (95% CI [0.39–0.49]) the risk of having a positive rapid diagnostic test for malaria. In addition, the programme indirectly reduced by 18% the risk of moderate-to-severe anemia (95% CI [0.15–0.21]). SMC in Mali has substantial protective effects under routine nationwide programme conditions. Endogenous treatment effects analyses can contribute to rigorously measuring the effectiveness of health programmes and to bridging a widening gap in evaluation methods to measure progress towards achieving malaria elimination.
format	article
author	Thomas Druetz
author_facet	Thomas Druetz
author_sort	Thomas Druetz
title	Evaluation of direct and indirect effects of seasonal malaria chemoprevention in Mali
title_short	Evaluation of direct and indirect effects of seasonal malaria chemoprevention in Mali
title_full	Evaluation of direct and indirect effects of seasonal malaria chemoprevention in Mali
title_fullStr	Evaluation of direct and indirect effects of seasonal malaria chemoprevention in Mali
title_full_unstemmed	Evaluation of direct and indirect effects of seasonal malaria chemoprevention in Mali
title_sort	evaluation of direct and indirect effects of seasonal malaria chemoprevention in mali
publisher	Nature Portfolio
publishDate	2018
url	https://doaj.org/article/12f9e69ed0b14ff1bbd03057533c5819
work_keys_str_mv	AT thomasdruetz evaluationofdirectandindirecteffectsofseasonalmalariachemopreventioninmali
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Evaluation of direct and indirect effects of seasonal malaria chemoprevention in Mali

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