Centre de Recherche en Epidémiologie, Biostatistique et Recherche Clinique, Ecole de Santé Publique, Université Libre de Bruxelles (ULB), Route de Lennik, 808, 1070, Brussels, Belgium.
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Malar J. 2022 May 6;21(1):143. doi: 10.1186/s12936-022-04172-z.
In 2014, the Burkina Faso government launched the Seasonal Malaria Chemoprevention (SMC) programme. Expected benefit was a 75% reduction of all malaria episodes and a 75% drop of severe malaria episodes. This study assessed SMC efficiency on malaria morbidity in the country after 2 years of implementation.
Quasi-experimental design comparing changes in outcomes during the high transmission period (August-November) between SMC and non-SMC health districts before (2013-2014) and after intervention (two rounds in 2015 and 2016). Health indicators (number of uncomplicated malaria cases (UM) and severe malaria cases (SM)) from 19 health districts (8 in intervention and 11 in comparison group) were extracted from the District Health Information System (DHIS2)-based platform including health facilities data. Effect on incidence was assessed by fitting difference-in difference mixed-effects negative binomial regression model at a log scale.
The two rounds of SMC were associated with a reduction of UM incidence (ratio of incidence rate ratio (IRR) 69% (95% CI 55-86%); p = 0.001) and SM incidence (ratio of IRR = 73% (55-95%), p = 0.018) among under five children.
The two rounds of SMC had a significant effect on the reduction of malaria cases in under five children. This additional evidence on the effectiveness of SMC, using routine data, support the need to sustain its implementation and consider expansion to eligible areas not yet covered.
2014 年,布基纳法索政府启动了季节性疟疾化学预防(SMC)计划。预期的效益是将所有疟疾病例减少 75%,重症疟疾病例减少 75%。本研究评估了该计划实施两年后对该国疟疾发病率的影响。
采用准实验设计,比较实施 SMC 和非 SMC 卫生区在高传播期(8 月至 11 月)的变化,比较卫生区在干预前(2013-2014 年)和干预后(2015 年和 2016 年两轮)的结果。从基于 District Health Information System(DHIS2)平台的 19 个卫生区(干预区 8 个,对照组 11 个)提取卫生指标(无并发症疟疾病例(UM)和重症疟疾病例(SM)数量),包括卫生设施数据。采用对数刻度拟合差异-差异混合效应负二项回归模型评估发病率的影响。
两轮 SMC 与五岁以下儿童 UM 发病率(发病率比(IRR)69%(95% CI 55-86%);p=0.001)和 SM 发病率(IRR 比=73%(55-95%),p=0.018)降低相关。
两轮 SMC 对五岁以下儿童疟疾病例的减少有显著影响。利用常规数据提供的 SMC 有效性的额外证据,支持继续实施并考虑扩大到尚未覆盖的合格地区的必要性。