Malaria Chemoprevention for the post-discharge management of severe anaemia in children in Malawi
BACKGROUND: Children hospitalised with severe anaemia in Africa are at high risk of readmission or death within 6 months after discharge. No strategy specifically addresses this post-discharge period. We recently showed that 3 months malaria chemoprevention with monthly Intermittent Preventive Therapy post-discharge (IPTpd) in Malawian children with severe anaemia prevented 31% of deaths and readmissions. The effect was in addition to the effect by bednets. These promising findings now need to be confirmed in other settings and the delivery mechanisms evaluated.
OBJECTIVES: To generate the evidence needed by WHO to consider IPTpd as a strategy to reduce post-discharge morbidity and mortality in malaria endemic areas in Africa.
MAJOR ACTIVITIES: This 5-year project comprises of:
1) Confirmatory Efficacy Trial in Kenya and Uganda: multi-centre, 2-arm, placebo-controlled, superiority trial of 3 courses of monthly IPTpd with dihydroartemisinin-piperaquine among 2212 children with severe anaemia. Composite primary endpoint: death and all-cause re-admission by 3 months;
2) Delivery mechanism trial in Malawi: Single-centre, cluster randomized, 4-arm factorial design trial in 380 children comparing the uptake, feasibility and acceptability of IPTpd delivered through outpatient departments or community based village health workers, with or without support from a phone text messaging reminder;
3) Impact analysis to define the target population and map the epidemiological and geographical settings in which IPTpd would be an appropriate intervention and estimate the potential public health impact through systematic reviews and modeling;
4) economical evaluation of the cost-effectiveness of IPTpd; and 5) IPTpd policy taskforce
to liaise with WHO.
Delivery strategies for malaria chemoprevention with monthly dihydroartemisinin-piperaquine for the post-discharge management of severe anaemia in children aged less than 5 years old in Malawi: a protocol for a cluster randomized trial
Thandile Gondwe, Bjarne Robberstad, Mavuto Mukaka, Siri Lange, Bjørn Blomberg, Kamija S. Phiri
Caretakers` acceptability of different delivery mechanisms of Post-discharge Malaria Chemoprevention (PMC) in Zomba, Southern Malawi A qualitative study under the GLOBVAC funded Post-discharge Malaria Chemoprevention Delivery (PMC) study
Sarah Svege, Blessings N Kaunda, Bjarne Robberstad, Kamija Phiri, Siri Lange
BMC Health Services Research
It Takes a Female Chief: Gender and Effective Policy Advocacy in Malawi
Ragnhild L. Muriaas, Vibeke Wang, Lindsay J. Benstead, Boniface Dulani and Lise Rakner
Who benefits from increased service utilisation? Examining the distributional effects of payment for performance in Tanzania
Peter John Binyaruka, Bjarne Robberstad, Gaute Torsvik, Josephine Borghi
International Journal for Equity in Health
Effects of Payment for Performance on accountability mechanisms: Evidence from Pwani, Tanzania
Iddy Mayumana, Jo Borghi, Laura Anselmi, Masuma Mamdani, Siri Lange
Social Science & Medicine
The health status of adolescents in Ecuador and the country’s response to the need for differentiated healthcare for adolescents
Joar Svanemyr, Susana Guijarro, Betzabe Butron Riveros, Venkatraman Chandra-Mouli
Globally designed accountability and local social inequality. A case study of two maternal deaths in Tanzania.
Edges of Global Transformation: Ethnographies of Uncertainty
Movimiento transnacional contra el derecho al aborto en América Latina
El aborto en América Latina Estrategias jurídicas para luchar por su legalización y enfrentar las resistencias conservadoras