Projected health impact of post-discharge malaria chemoprevention among children with severe malarial anaemia in Africa

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Title: Projected health impact of post-discharge malaria chemoprevention among children with severe malarial anaemia in Africa
Authors: Okell, LC
Kwambai, TK
Dhabangi, A
Khairallah, C
Nkosi-Gondwe, T
Winskill, P
Opoka, R
Mousa, A
Kühl, M-J
Lucas, TCD
Challenger, JD
Idro, R
Weiss, DJ
Cairns, M
Ter Kuile, FO
Phiri, K
Robberstad, B
Mori, AT
Item Type: Journal Article
Abstract: Children recovering from severe malarial anaemia (SMA) remain at high risk of readmission and death after discharge from hospital. However, a recent trial found that post-discharge malaria chemoprevention (PDMC) with dihydroartemisinin-piperaquine reduces this risk. We developed a mathematical model describing the daily incidence of uncomplicated and severe malaria requiring readmission among 0–5-year old children after hospitalised SMA. We fitted the model to a multicentre clinical PDMC trial using Bayesian methods and modelled the potential impact of PDMC across malaria-endemic African countries. In the 20 highest-burden countries, we estimate that only 2–5 children need to be given PDMC to prevent one hospitalised malaria episode, and less than 100 to prevent one death. If all hospitalised SMA cases access PDMC in moderate-to-high transmission areas, 38,600 (range 16,900–88,400) malaria-associated readmissions could be prevented annually, depending on access to hospital care. We estimate that recurrent SMA post-discharge constitutes 19% of all SMA episodes in moderate-to-high transmission settings.
Issue Date: 25-Jan-2023
Date of Acceptance: 9-Jan-2023
DOI: 10.1038/s41467-023-35939-w
ISSN: 2041-1723
Publisher: Nature Research
Start Page: 1
End Page: 10
Journal / Book Title: Nature Communications
Volume: 14
Copyright Statement: © The Author(s) 2023 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit
Publication Status: Published
Article Number: 402
Online Publication Date: 2023-01-25
Appears in Collections:Department of Infectious Diseases
Faculty of Medicine
School of Public Health

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