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Sub-National Targeting of Seasonal Malaria Chemoprevention in the Sahelian Countries of the Nouakchott Initiative.

Noor AM, Kibuchi E, Mitto B, Coulibaly D, Doumbo OK, Snow RW - PLoS ONE (2015)

Bottom Line: In 2015 alone, an estimated 49-72 million SP tablets and 148-217 million AQ tablets will be needed to cover all or rural children respectively under the different scenarios of upper age limits.Our proposed framework provides a standardised approach to support targeting and scale up of SMC by the countries of the Nouakchott Initiative.Our analysis suggests that the vast majority of the population in this region are likely to benefit from SMC and substantial resources will be required to reach universal coverage each year.

View Article: PubMed Central - PubMed

Affiliation: INFORM (Information for Malaria - www.inform-malaria.org), Spatial Health Metrics Group, Kenya Medical Research Institute/Wellcome Trust Research Programme, Nairobi, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.

ABSTRACT

Background: Seasonal malaria chemoprevention (SMC) has been shown to be highly efficacious against clinical malaria in areas where transmission is acutely seasonal. SMC targeting depends on a complex interplay of climate, malaria transmission and population distribution. In this study a spatial decision support framework was developed to identify health districts suitable for the targeting of SMC across seven Sahelian countries and northern states of Nigeria that are members of the Nouakchott Initiative.

Methods: A spatially explicit decision support framework that links information on seasonality, age-structured population, urbanization, malaria endemicity and the length of transmission season was developed to inform SMC targeting in health districts. Thresholds of seasonality, population and receptive risks were defined to delineate SMC suitable health districts and define the age range of children for targeting. Numbers of children were then computed for the period 2015-2020 in SMC districts. For 2015, this was combined with maps of length of malaria transmission seasons and WHO recommended treatment regimen to quantify the number of tablets required across the SMC health districts.

Results: A total of 597 Sahelian health districts were mapped, out of which 478 (80.1%) were considered suitable for SMC based on seasonality and endemicity thresholds. These districts had an estimated 119.8 million (85%) of the total population in 2015. In the six years from 2015-2020, it is estimated that a total of 158 million children 3m to <5 years, 121 million of whom were in rural areas, will need SMC to achieve universal coverage in the Sahel. If the upper age limit of SMC targeted children was increased to <10 years in low transmission districts, a total 177 million overall, of whom 135 million were rural children, will require chemoprevention in 2015-2020. In 2015 alone, an estimated 49-72 million SP tablets and 148-217 million AQ tablets will be needed to cover all or rural children respectively under the different scenarios of upper age limits.

Conclusions: Our proposed framework provides a standardised approach to support targeting and scale up of SMC by the countries of the Nouakchott Initiative. Our analysis suggests that the vast majority of the population in this region are likely to benefit from SMC and substantial resources will be required to reach universal coverage each year.

No MeSH data available.


Related in: MedlinePlus

A spatial decision support framework for identifying areas suitable for seasonal chemoprevention and quantifying the size of the population of target children and the amount of the required antimalarial tablets.For additional details of the definition of inputs, processes and outputs see the S1 File.
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pone.0136919.g001: A spatial decision support framework for identifying areas suitable for seasonal chemoprevention and quantifying the size of the population of target children and the amount of the required antimalarial tablets.For additional details of the definition of inputs, processes and outputs see the S1 File.

Mentions: The spatial decision support framework for SMC targeting that we propose in this study (Fig 1) is different to previous work [6] in several important aspects. A 2000 P. falciparum malaria risk map [5], an approximate measure of receptive risks prior to the large scale up of malaria interventions, is used to define endemicity thresholds for SMC suitability. A 2010 P. falciparum malaria risk map [5] is used to identify areas where the option of increasing the age class of target children from 3 months to below 5 years to up to below 10 years may confer greater benefit from SMC. We resolve Information to current health decision-making units, known as health districts, and age-structured populations within their boundaries are classified into urban and rural. The numbers of children that require SMC are estimated for the period 2015–2020 using population projections. Finally, median number of malaria transmission months is computed per health district to allow for the quantification of the amount of SP and AQ tablets required to achieve universal coverage in SMC districts in 2015.


Sub-National Targeting of Seasonal Malaria Chemoprevention in the Sahelian Countries of the Nouakchott Initiative.

Noor AM, Kibuchi E, Mitto B, Coulibaly D, Doumbo OK, Snow RW - PLoS ONE (2015)

A spatial decision support framework for identifying areas suitable for seasonal chemoprevention and quantifying the size of the population of target children and the amount of the required antimalarial tablets.For additional details of the definition of inputs, processes and outputs see the S1 File.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554730&req=5

pone.0136919.g001: A spatial decision support framework for identifying areas suitable for seasonal chemoprevention and quantifying the size of the population of target children and the amount of the required antimalarial tablets.For additional details of the definition of inputs, processes and outputs see the S1 File.
Mentions: The spatial decision support framework for SMC targeting that we propose in this study (Fig 1) is different to previous work [6] in several important aspects. A 2000 P. falciparum malaria risk map [5], an approximate measure of receptive risks prior to the large scale up of malaria interventions, is used to define endemicity thresholds for SMC suitability. A 2010 P. falciparum malaria risk map [5] is used to identify areas where the option of increasing the age class of target children from 3 months to below 5 years to up to below 10 years may confer greater benefit from SMC. We resolve Information to current health decision-making units, known as health districts, and age-structured populations within their boundaries are classified into urban and rural. The numbers of children that require SMC are estimated for the period 2015–2020 using population projections. Finally, median number of malaria transmission months is computed per health district to allow for the quantification of the amount of SP and AQ tablets required to achieve universal coverage in SMC districts in 2015.

Bottom Line: In 2015 alone, an estimated 49-72 million SP tablets and 148-217 million AQ tablets will be needed to cover all or rural children respectively under the different scenarios of upper age limits.Our proposed framework provides a standardised approach to support targeting and scale up of SMC by the countries of the Nouakchott Initiative.Our analysis suggests that the vast majority of the population in this region are likely to benefit from SMC and substantial resources will be required to reach universal coverage each year.

View Article: PubMed Central - PubMed

Affiliation: INFORM (Information for Malaria - www.inform-malaria.org), Spatial Health Metrics Group, Kenya Medical Research Institute/Wellcome Trust Research Programme, Nairobi, Kenya; Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom.

ABSTRACT

Background: Seasonal malaria chemoprevention (SMC) has been shown to be highly efficacious against clinical malaria in areas where transmission is acutely seasonal. SMC targeting depends on a complex interplay of climate, malaria transmission and population distribution. In this study a spatial decision support framework was developed to identify health districts suitable for the targeting of SMC across seven Sahelian countries and northern states of Nigeria that are members of the Nouakchott Initiative.

Methods: A spatially explicit decision support framework that links information on seasonality, age-structured population, urbanization, malaria endemicity and the length of transmission season was developed to inform SMC targeting in health districts. Thresholds of seasonality, population and receptive risks were defined to delineate SMC suitable health districts and define the age range of children for targeting. Numbers of children were then computed for the period 2015-2020 in SMC districts. For 2015, this was combined with maps of length of malaria transmission seasons and WHO recommended treatment regimen to quantify the number of tablets required across the SMC health districts.

Results: A total of 597 Sahelian health districts were mapped, out of which 478 (80.1%) were considered suitable for SMC based on seasonality and endemicity thresholds. These districts had an estimated 119.8 million (85%) of the total population in 2015. In the six years from 2015-2020, it is estimated that a total of 158 million children 3m to <5 years, 121 million of whom were in rural areas, will need SMC to achieve universal coverage in the Sahel. If the upper age limit of SMC targeted children was increased to <10 years in low transmission districts, a total 177 million overall, of whom 135 million were rural children, will require chemoprevention in 2015-2020. In 2015 alone, an estimated 49-72 million SP tablets and 148-217 million AQ tablets will be needed to cover all or rural children respectively under the different scenarios of upper age limits.

Conclusions: Our proposed framework provides a standardised approach to support targeting and scale up of SMC by the countries of the Nouakchott Initiative. Our analysis suggests that the vast majority of the population in this region are likely to benefit from SMC and substantial resources will be required to reach universal coverage each year.

No MeSH data available.


Related in: MedlinePlus