Evaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in Northern Sahelian Ghana

Abstract Background In Sahelian Africa, the risk of malaria increases with the arrival of the rains, particularly in young children. Following successful trials, the World Health Organization (WHO) recommended the use of seasonal malaria chemoprevention (SMC) in areas with seasonal peak in malaria c...

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Autores principales:	Patrick O. Ansah, Nana A. Ansah, Keziah Malm, Dennis Awuni, Nana Peprah, Sylvester Dassah, Sobe Yarig, Charles Manful, John Agbenyeri, John Awoonor-Williams, Wilfred Ofosu, Abraham R. Oduro
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Feasibility Seasonal-malaria-chemoprevention Children Northern Ghana Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/c3f813d37129482d84e4c8b257f753e1
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spelling	oai:doaj.org-article:c3f813d37129482d84e4c8b257f753e12021-11-21T12:33:44ZEvaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in Northern Sahelian Ghana10.1186/s12936-021-03974-x1475-2875https://doaj.org/article/c3f813d37129482d84e4c8b257f753e12021-11-01T00:00:00Zhttps://doi.org/10.1186/s12936-021-03974-xhttps://doaj.org/toc/1475-2875Abstract Background In Sahelian Africa, the risk of malaria increases with the arrival of the rains, particularly in young children. Following successful trials, the World Health Organization (WHO) recommended the use of seasonal malaria chemoprevention (SMC) in areas with seasonal peak in malaria cases. This study evaluated the pilot implementation of SMC in Northern Ghana. Methods Fourteen communities each serving as clusters were selected randomly from Lawra District of Upper West Region as intervention area and West Mamprusi District in the Northern Region as the non-intervention area. The intervention was undertaken by the National Malaria Control Programme in collaboration with regional health directorates using sulfadoxine-pyrimethamine plus amodiaquine and standard WHO protocols. Before and after surveys for malaria parasitaemia and haemoglobin levels as well as monitoring for malaria morbidity and mortality were undertaken. Results At the end of the intervention, participant retention was 92.9% (697/731) and 89.5% (634/708) in the intervention and the non-intervention areas, respectively. The proportion of children with asexual parasites reduced by 19% (p = 0.000) in the intervention and increased by 12% (p = 0.000) in the non-intervention area. Incidence rates of severe malaria were 10 and 20 per 1000 person-years follow up in the intervention and comparison areas, respectively with P.E of 45% (p = 0.62). For mild malaria, it was 220 and 170 per 1000 person-years in intervention and comparison area, respectively with PE of - 25% (p = 0.31). The proportion of children with anaemia defined as Hb< 11.0 g/dl reduced from 14.2% (52.8–38.6%) in the intervention area as compared to an increase of 8.1% (54.5% to 62.6) the non-intervention arm, Mean Hb reduced by 0. 24 g/dl (p = 0.000) in the non-intervention area and increased of 0.39 g/dl (p = 000) in the intervention area. Conclusions The feasibility and effectiveness of SMC introduction in Northern Ghana was demonstrated as evidenced by high study retention, reduction in malaria parasitaemia and anaemia during the wet season.Patrick O. AnsahNana A. AnsahKeziah MalmDennis AwuniNana PeprahSylvester DassahSobe YarigCharles ManfulJohn AgbenyeriJohn Awoonor-WilliamsWilfred OfosuAbraham R. OduroBMCarticleFeasibilitySeasonal-malaria-chemopreventionChildrenNorthern GhanaArctic medicine. Tropical medicineRC955-962Infectious and parasitic diseasesRC109-216ENMalaria Journal, Vol 20, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Feasibility Seasonal-malaria-chemoprevention Children Northern Ghana Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216
spellingShingle	Feasibility Seasonal-malaria-chemoprevention Children Northern Ghana Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Patrick O. Ansah Nana A. Ansah Keziah Malm Dennis Awuni Nana Peprah Sylvester Dassah Sobe Yarig Charles Manful John Agbenyeri John Awoonor-Williams Wilfred Ofosu Abraham R. Oduro Evaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in Northern Sahelian Ghana
description	Abstract Background In Sahelian Africa, the risk of malaria increases with the arrival of the rains, particularly in young children. Following successful trials, the World Health Organization (WHO) recommended the use of seasonal malaria chemoprevention (SMC) in areas with seasonal peak in malaria cases. This study evaluated the pilot implementation of SMC in Northern Ghana. Methods Fourteen communities each serving as clusters were selected randomly from Lawra District of Upper West Region as intervention area and West Mamprusi District in the Northern Region as the non-intervention area. The intervention was undertaken by the National Malaria Control Programme in collaboration with regional health directorates using sulfadoxine-pyrimethamine plus amodiaquine and standard WHO protocols. Before and after surveys for malaria parasitaemia and haemoglobin levels as well as monitoring for malaria morbidity and mortality were undertaken. Results At the end of the intervention, participant retention was 92.9% (697/731) and 89.5% (634/708) in the intervention and the non-intervention areas, respectively. The proportion of children with asexual parasites reduced by 19% (p = 0.000) in the intervention and increased by 12% (p = 0.000) in the non-intervention area. Incidence rates of severe malaria were 10 and 20 per 1000 person-years follow up in the intervention and comparison areas, respectively with P.E of 45% (p = 0.62). For mild malaria, it was 220 and 170 per 1000 person-years in intervention and comparison area, respectively with PE of - 25% (p = 0.31). The proportion of children with anaemia defined as Hb< 11.0 g/dl reduced from 14.2% (52.8–38.6%) in the intervention area as compared to an increase of 8.1% (54.5% to 62.6) the non-intervention arm, Mean Hb reduced by 0. 24 g/dl (p = 0.000) in the non-intervention area and increased of 0.39 g/dl (p = 000) in the intervention area. Conclusions The feasibility and effectiveness of SMC introduction in Northern Ghana was demonstrated as evidenced by high study retention, reduction in malaria parasitaemia and anaemia during the wet season.
format	article
author	Patrick O. Ansah Nana A. Ansah Keziah Malm Dennis Awuni Nana Peprah Sylvester Dassah Sobe Yarig Charles Manful John Agbenyeri John Awoonor-Williams Wilfred Ofosu Abraham R. Oduro
author_facet	Patrick O. Ansah Nana A. Ansah Keziah Malm Dennis Awuni Nana Peprah Sylvester Dassah Sobe Yarig Charles Manful John Agbenyeri John Awoonor-Williams Wilfred Ofosu Abraham R. Oduro
author_sort	Patrick O. Ansah
title	Evaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in Northern Sahelian Ghana
title_short	Evaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in Northern Sahelian Ghana
title_full	Evaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in Northern Sahelian Ghana
title_fullStr	Evaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in Northern Sahelian Ghana
title_full_unstemmed	Evaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in Northern Sahelian Ghana
title_sort	evaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in northern sahelian ghana
publisher	BMC
publishDate	2021
url	https://doaj.org/article/c3f813d37129482d84e4c8b257f753e1
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Evaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in Northern Sahelian Ghana

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