Evaluating the effectiveness and sustainability of integrating helminth control with seasonal malaria chemoprevention in West African children

评估西非儿童蠕虫控制与季节性疟疾化学预防相结合的有效性和可持续性

• 批准号: MR/X023133/1
• 负责人: Muhammed Afolabi
• 金额: $ 68.32万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FX023133%2F1
• 关键词: Evaluating; effectiveness; sustainability; integrating; helminth

Malaria remains a major health problem, especially in sub-Saharan Africa where more than 90% of the disease and deaths occur in children. Adding to this high burden among children is the co-existence of parasitic worms. Existing control programmes for the worms are operating sub-optimally despite the 2012 London Declaration of eliminating some of the parasitic worms by 2020. On the other hand, a malaria prevention programme, called Seasonal Malaria Chemoprevention (SMC), introduced the same year in 2012 has achieved better coverage and prevented a substantial proportion of deaths in children. This encouraging development supports the need to explore the strategies involving the integration of worm control with successful platforms such as SMC. This would align parasitic worm and malaria control with the Sustainable Development Goals of ending diseases of poverty and promoting health and well-being for those at risk.To achieve these goals, I implemented four different research studies to quantify the burden of mixed infections with malaria and parasitic worms among children living in poor countries of the world. I also used the findings of my research studies to test the feasibility and safety of combining malaria and worm treatment together among children living in Senegal, West Africa. The findings of this study showed that the integration of mass deworming with antimalarial drugs was feasible, well-tolerated, and acceptable to children and their parents. To maximise the impact of my findings, I propose in this renewal fellowship, an evaluation of the effectiveness and sustainability of integrated malaria and worm control approach in a high-burden country. Having established the feasibility and safety of the integrated approach, it is now important to investigate the overall impact and cost-effectiveness of this approach in a larger population than was included in the pilot study. It is also important to obtain information on the operational costs and cost-effectiveness of an integrated delivery model for malaria and parasitic worms among children. This economic analysis will be needed to inform resource allocations, allow comparison with alternative interventions, and inform the deployment of the approach. This fellowship renewal will focus on two main objectives: 1) to evaluate the effectiveness of combining antimalarial and deworming drugs in reducing the prevalence of anaemia and the intensity of malaria-helminth co-infections among a population of pre-school and school-age children resident in a high-burden country. 2) to determine the cost and cost-effectiveness of delivering the integrated malaria-deworming approach to children. To achieve these objectives, I will conduct an intervention study where 1200 children in 10 villages in an endemic country in West Africa will be recruited and divided by their households into two equal groups. One group will receive the antimalarial drugs only, while the second group will receive deworming drugs along with antimalarial medications. Blood, urine and stool samples will be collected from the children in the two groups before and after giving them these medications to check whether there are any changes in their blood level (haemoglobin concentration) and malaria and worm parasite levels. To determine if this new approach is affordable and sustainable, a detailed costing analysis of the incremental financial and economic costs of implementing the integrated treatment will be done.The findings of this new study will significantly consolidate the achievements I have made during the first part of my UKRI fellowship in developing strategic interventions for integrated malaria-neglected tropical diseases (NTD) control, which could help to eliminate malaria and parasitic worms by 2030. This will also equip me with the skill set to become established as a globally visible Research Leader in integrated malaria-NTD elimination strategies.

疟疾仍然是一个主要的健康问题，尤其是在撒哈拉以南非洲，儿童中有90％以上的疾病和死亡发生。寄生蠕虫的共存还增加了儿童中这种高负担。尽管2012年伦敦宣布消除了到2020年的一些寄生虫蠕虫，但现有的蠕虫的控制程序仍是最佳的。另一方面，2012年推出的一项称为季节性疟疾化学预防症（SMC）的疟疾预防计划（SMC）在2012年引入了同一年，在2012年获得了更好的覆盖范围，并预防了儿童死亡的实质性覆盖范围。这种令人鼓舞的开发支持了探索涉及蠕虫控制与成功平台（例如SMC）集成的策略的需求。这将使寄生虫和疟疾的控制与结束贫困疾病的可持续发展目标，并为处于危险中的人们促进健康和福祉的可持续发展目标。为了实现这些目标，我实施了四项不同的研究，以量化生活在世界贫困国家的疟疾和寄生虫蠕虫的混合感染负担。我还利用研究研究结果来测试居住在西非塞内加尔的儿童中疟疾和蠕虫治疗合并在一起的可行性和安全性。这项研究的发现表明，质量驱虫与抗疟药的整合是可行的，良好的且耐受性的，并且可以接受儿童及其父母。为了最大程度地提高我的发现的影响，我在这个更新的奖学金中提出了对综合疟疾和蠕虫控制方法在一个高负年国家的有效性和可持续性的评估。建立了综合方法的可行性和安全性后，现在研究这种方法在大人群中的总体影响和成本效益与试点研究相比，重要的是重要。获取有关儿童疟疾和寄生虫综合交付模型的运营成本和成本效益的信息也很重要。需要进行经济分析来为资源分配提供信息，允许与替代干预措施进行比较，并告知该方法的部署。该奖学金的更新将集中在两个主要目标上：1）评估抗疟药和驱虫药物在降低贫血的患病率以及疟疾 - 基因共同感染强度方面相结合的有效性。 2）确定为儿童提供综合疟疾消除方法的成本和成本效益。为了实现这些目标，我将进行一项干预研究，其中将在西非一个地方性国家的10个村庄中有1200名儿童被其家庭分为两个平等群体。一组将仅接受抗疟药，而第二组将接受驱虫药以及抗疟疾药物。给他们这些药物之前和之后，将从两组的儿童中收集血液，尿液和粪便样本，以检查其血液水平（血红蛋白浓度）以及疟疾和蠕虫寄生虫水平是否有任何变化。要确定这种新方法是否负担得起且可持续，将进行实施综合处理的渐进财务和经济成本的详细成本分析。这项新研究的发现将显着巩固我在我在乌克里（Ukri）的第一部分中取得的成就2030年。这也将使我拥有成为综合疟疾NTD消除策略的全球可见研究领导者的技能。