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Post-discharge malaria chemoprevention in children with severe anaemia in Benin, Kenya, Malawi and Uganda: Formative and implementation research for policy decision making and implementation

Project description

Saving lives in sub-Saharan Africa

Children in sub-Saharan Africa face a significant risk of severe anaemia and mortality, even after they have been discharged from the hospital. A recent study has discovered that providing post-discharge malaria chemoprevention (PDMC) for a duration of 3 months can lead to a 53 % reduction in readmissions and a 77 % decrease in post-discharge deaths. As a response to this compelling evidence, the WHO recommends the use of PDMC in highly malaria-endemic areas across Africa. In this context, the EU-funded PDMC Saves Lives project uses research to establish policy guidelines aimed at promoting life-saving medicines for vulnerable children. In countries such as Benin, Kenya, Malawi and Uganda, it will pinpoint research questions pertaining to the implementation of PDMC.

Objective

Background: Young children in sub-Saharan Africa are at high risk of severe anaemia, associated with high mortality. Children who have recently recovered from severe anaemia in malaria-endemic areas remain at high risk of mortality for about 3-6 months after hospital discharge. Three months of post-discharge malaria chemoprevention (PDMC) has recently been shown to reduce hospital readmissions by 53% and post-discharge deaths by 77%. WHO now recommends PDMC in all highly malaria-endemic areas of Africa. However, the optimal strategies for how to deliver PDMC are not yet clear.

Objective: To undertake implementation research and translate results into national policy guidelines to promote PDMC uptake into clinical practice so that vulnerable children have access to life-saving medicines.

Study design: i) Formative research in two countries in the process of adopting PDMC (Malawi and Uganda) and two, not yet (Kenya and Benin), to identify key research questions for PDMC implementation. ii) Two implementation trials (Benin and Kenya, N=1,824) in recently discharged children following recovery from severe anaemia, co-designed with national stakeholders, will evaluate at least two PDMC delivery strategies involving community-health workers and automated SMS reminders. The primary outcome will be adherence. Secondary outcomes include clinical and cost-effectiveness, and acceptability and feasibility.

Interdisciplinary studies: Acceptability and feasibility; Cost-effectiveness; Policy analysis.

Timeline: 42 months: 9m preparation/formative research, 18m trial implementation, 6m analysis + 9m dissemination/exploitation and PhD completion.

Impact: The project is designed to provide evidence to support PDMC implementation.

Partners: Institut De Recherche Pour Le Developpement, France (coordinating partner); LSTM, UK ; EPICENTRE, France; Institut de Recherche Clinique du Benin; Training and Research Unit of Excellence, Malawi; Makerere Uni, Uganda; Kenya Medical Research Institute, Kenya

Programme(s)

Coordinator

INSTITUT DE RECHERCHE POUR LE DEVELOPPEMENT
Net EU contribution
€ 395 728,31
Address
BOULEVARD DE DUNKERQUE 44 CS 90009
13572 Marseille
France

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Region
Provence-Alpes-Côte d’Azur Provence-Alpes-Côte d’Azur Bouches-du-Rhône
Activity type
Research Organisations
Links
Total cost
€ 395 728,31

Participants (5)

Partners (1)