"Investigating the rebound effects of seasonal malaria chemoprevention (SMC) in Mali"

“调查马里季节性疟疾化学预防 (SMC) 的反弹效果”

• 批准号: 10451972
• 负责人: Mahamoudou Toure
• 金额: $ 13.33万
• 依托单位: UNIV OF SCIENCES, TECH & TECH OF BAMAKO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-05 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10451972
• 关键词: 4 year old; 5 year old; 8 year old; 9 year old; Adopted; Africa South of the Sahara; Age; Amodiaquine; Anemia; Antibody Response; Antigens; Antimalarials; Area; Artemisinins; Biological; Blood; Chemoprevention; Child; Cohort Studies; Combined Modality Therapy; Communities; Control Groups; Country; Culicidae; Data; Development; Disease; Dose; Effectiveness; Eligibility Determination; Enrollment; Exposure to; Fever; Genetic Transcription; Genomics; Health; Hospitalization; Human; Immune response; Immunity; Immunologic Markers; Impairment; Incidence; Infection; Insecticides; Intervention; Longitudinal cohort study; Malaria; Mali; Measures; Merozoite Surface Protein 1; Monitor; Morbidity - disease rate; Nested Case-Control Study; Outcome; Parasites; Phase; Plasmodium falciparum; Polymerase Chain Reaction; Population; Prevalence; Prospective cohort study; Pyrimethamine-Sulfadoxine; Regimen; Reporting; Research; Risk; Seasons; Severities; Structure; Surveys; Therapeutic; Treatment Protocols; Withdrawal; Work; World Health Organization; age group; aged; asexual; base; case control; cohort; compliance behavior; improved; low and middle-income countries; malaria infection; malaria transmission; malarial anemia; mortality; non-compliance; prevent; programs; prophylactic; scale up; transmission process; trend

Summary Seasonal Malaria Chemoprevention (SMC) has been recommended by WHO for malaria endemic countries in sub-Saharan Africa with strong seasonal malaria transmission since 2012. The intervention consists of the administration of full treatment doses of Sulfadoxine-Pyrimethamine (SP) plus Amodiaquine to children less than 5 years of age every 4 weeks during the malaria transmission season for 3 to 4 rounds per year. Since 2016, Mali has implemented the strategy countrywide. While significant decreases in malaria cases among the target age group was observed, increasing trends in malaria among children 5 years and above is also reported in the many settings where SMC is being implemented. The proposed study considers previous studies and pilot data showing that approximately out of every eight children (12.5%) have historically received either no doses or a single dose out of a the required four doses for the treatment regimen. This study seeks to enroll a large cohort of children to permit a large-scale comparison between children previously compliant to SMC with a valid control group (children not previously compliant to SMC) to elucidate the effects of phasing out of the SMC program due to age ineligibility. The primary objective of this R01 proposal is to investigate the withdrawal effects of SMC due to age eligibility requirements through the following three specific aims: 1) Determine malaria rebound occurrence following SMC enrollment including its association with severe malaria and anemia; 2) Assess changes in the age-specific P. falciparum prevalence, sexual and asexual parasites, and multiplicity of infection following SMC deployment; and 3) Assess the change in immune response to malaria antigens during and following SMC eligibility and the relationship with disease. The study will provide valuable information on the impact of SMC stoppage at five years of age which can significant contribute improving monitoring malaria outcomes in other low- and middle-income countries overall.

概括 世界卫生组织已建议疟疾流行国家进行季节性疟疾化学预防（SMC） 自 2012 年以来，撒哈拉以南非洲地区季节性疟疾传播严重。干预措施包括 对小于或等于以下的儿童给予全额治疗剂量的磺胺多辛-乙胺嘧啶 (SP) 加阿莫地喹 5 岁以下，在疟疾传播季节每 4 周一次，每年 3 至 4 轮。自2016年以来， 马里已在全国范围内实施该战略。虽然目标中的疟疾病例显着减少 根据观察年龄组的情况，《报告》还报告了 5 岁及以上儿童的疟疾呈增加趋势。 许多实施 SMC 的环境。拟议的研究考虑了之前的研究和试点数据 显示大约每八名儿童中的一员 (12.5%) 历史上没有接受过剂量或接受过剂量 治疗方案所需的四剂中的单剂。这项研究旨在招募大量人群 的儿童，以允许对先前符合 SMC 的儿童与有效对照进行大规模比较 小组（以前不遵守 SMC 的儿童）阐明逐步取消 SMC 计划的影响，因为 到年龄不合格。该 R01 提案的主要目标是研究 SMC 的退出效应 由于年龄资格要求，通过以下三个具体目标： 1) 确定疟疾反弹 SMC 入组后发生的情况，包括其与严重疟疾和贫血的关联； 2）评估 特定年龄的恶性疟原虫患病率、有性和无性寄生虫以及感染复数的变化 部署 SMC 后； 3) 评估在 和 期间对疟疾抗原的免疫反应的变化 以下为 SMC 资格及其与疾病的关系。该研究将提供有关以下方面的宝贵信息： 五岁时 SMC 停止的影响可显着改善疟疾监测 其他低收入和中等收入国家的总体成果。