Perennial malaria chemoprevention with and without malaria vaccination to reduce malaria burden in young children: a modelling analysis
Abstract Background A recent WHO recommendation for perennial malaria chemoprevention (PMC) encourages countries to adapt dose timing and number to local conditions. However, knowledge gaps on the epidemiological impact of PMC and possible combination with the malaria vaccine RTS,S hinder informed p...
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ftdoajarticles:oai:doaj.org/article:d6640a93d961412981943992a6cc7333 2023-06-11T04:10:02+02:00 Perennial malaria chemoprevention with and without malaria vaccination to reduce malaria burden in young children: a modelling analysis Manuela Runge Anne Stahlfeld Monique Ambrose Kok Ben Toh Semiu Rahman Omowunmi F. Omoniwa Caitlin A. Bever Olusola Oresanya Perpetua Uhomoibhi Beatriz Galatas James K. Tibenderana Jaline Gerardin 2023-04-01T00:00:00Z https://doi.org/10.1186/s12936-023-04564-9 https://doaj.org/article/d6640a93d961412981943992a6cc7333 EN eng BMC https://doi.org/10.1186/s12936-023-04564-9 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-023-04564-9 1475-2875 https://doaj.org/article/d6640a93d961412981943992a6cc7333 Malaria Journal, Vol 22, Iss 1, Pp 1-13 (2023) PMC RTS,S Nigeria Mathematical modeling Malaria modeling Malaria prevention Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2023 ftdoajarticles https://doi.org/10.1186/s12936-023-04564-9 2023-05-07T00:36:06Z Abstract Background A recent WHO recommendation for perennial malaria chemoprevention (PMC) encourages countries to adapt dose timing and number to local conditions. However, knowledge gaps on the epidemiological impact of PMC and possible combination with the malaria vaccine RTS,S hinder informed policy decisions in countries where malaria burden in young children remains high. Methods The EMOD malaria model was used to predict the impact of PMC with and without RTS,S on clinical and severe malaria cases in children under the age of two years (U2). PMC and RTS,S effect sizes were fit to trial data. PMC was simulated with three to seven doses (PMC-3-7) before the age of eighteen months and RTS,S with three doses, shown to be effective at nine months. Simulations were run for transmission intensities of one to 128 infectious bites per person per year, corresponding to incidences of < 1 to 5500 cases per 1000 population U2. Intervention coverage was either set to 80% or based on 2018 household survey data for Southern Nigeria as a sample use case. The protective efficacy (PE) for clinical and severe cases in children U2 was calculated in comparison to no PMC and no RTS,S. Results The projected impact of PMC or RTS,S was greater at moderate to high transmission than at low or very high transmission. Across the simulated transmission levels, PE estimates of PMC-3 at 80% coverage ranged from 5.7 to 8.8% for clinical, and from 6.1 to 13.6% for severe malaria (PE of RTS,S 10–32% and 24.6–27.5% for clinical and severe malaria, respectively. In children U2, PMC with seven doses nearly averted as many cases as RTS,S, while the combination of both was more impactful than either intervention alone. When operational coverage, as seen in Southern Nigeria, increased to a hypothetical target of 80%, cases were reduced beyond the relative increase in coverage. Conclusions PMC can substantially reduce clinical and severe cases in the first two years of life in areas with high malaria burden and perennial transmission. A better ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 22 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
topic |
PMC RTS,S Nigeria Mathematical modeling Malaria modeling Malaria prevention Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
PMC RTS,S Nigeria Mathematical modeling Malaria modeling Malaria prevention Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Manuela Runge Anne Stahlfeld Monique Ambrose Kok Ben Toh Semiu Rahman Omowunmi F. Omoniwa Caitlin A. Bever Olusola Oresanya Perpetua Uhomoibhi Beatriz Galatas James K. Tibenderana Jaline Gerardin Perennial malaria chemoprevention with and without malaria vaccination to reduce malaria burden in young children: a modelling analysis |
topic_facet |
PMC RTS,S Nigeria Mathematical modeling Malaria modeling Malaria prevention Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background A recent WHO recommendation for perennial malaria chemoprevention (PMC) encourages countries to adapt dose timing and number to local conditions. However, knowledge gaps on the epidemiological impact of PMC and possible combination with the malaria vaccine RTS,S hinder informed policy decisions in countries where malaria burden in young children remains high. Methods The EMOD malaria model was used to predict the impact of PMC with and without RTS,S on clinical and severe malaria cases in children under the age of two years (U2). PMC and RTS,S effect sizes were fit to trial data. PMC was simulated with three to seven doses (PMC-3-7) before the age of eighteen months and RTS,S with three doses, shown to be effective at nine months. Simulations were run for transmission intensities of one to 128 infectious bites per person per year, corresponding to incidences of < 1 to 5500 cases per 1000 population U2. Intervention coverage was either set to 80% or based on 2018 household survey data for Southern Nigeria as a sample use case. The protective efficacy (PE) for clinical and severe cases in children U2 was calculated in comparison to no PMC and no RTS,S. Results The projected impact of PMC or RTS,S was greater at moderate to high transmission than at low or very high transmission. Across the simulated transmission levels, PE estimates of PMC-3 at 80% coverage ranged from 5.7 to 8.8% for clinical, and from 6.1 to 13.6% for severe malaria (PE of RTS,S 10–32% and 24.6–27.5% for clinical and severe malaria, respectively. In children U2, PMC with seven doses nearly averted as many cases as RTS,S, while the combination of both was more impactful than either intervention alone. When operational coverage, as seen in Southern Nigeria, increased to a hypothetical target of 80%, cases were reduced beyond the relative increase in coverage. Conclusions PMC can substantially reduce clinical and severe cases in the first two years of life in areas with high malaria burden and perennial transmission. A better ... |
format |
Article in Journal/Newspaper |
author |
Manuela Runge Anne Stahlfeld Monique Ambrose Kok Ben Toh Semiu Rahman Omowunmi F. Omoniwa Caitlin A. Bever Olusola Oresanya Perpetua Uhomoibhi Beatriz Galatas James K. Tibenderana Jaline Gerardin |
author_facet |
Manuela Runge Anne Stahlfeld Monique Ambrose Kok Ben Toh Semiu Rahman Omowunmi F. Omoniwa Caitlin A. Bever Olusola Oresanya Perpetua Uhomoibhi Beatriz Galatas James K. Tibenderana Jaline Gerardin |
author_sort |
Manuela Runge |
title |
Perennial malaria chemoprevention with and without malaria vaccination to reduce malaria burden in young children: a modelling analysis |
title_short |
Perennial malaria chemoprevention with and without malaria vaccination to reduce malaria burden in young children: a modelling analysis |
title_full |
Perennial malaria chemoprevention with and without malaria vaccination to reduce malaria burden in young children: a modelling analysis |
title_fullStr |
Perennial malaria chemoprevention with and without malaria vaccination to reduce malaria burden in young children: a modelling analysis |
title_full_unstemmed |
Perennial malaria chemoprevention with and without malaria vaccination to reduce malaria burden in young children: a modelling analysis |
title_sort |
perennial malaria chemoprevention with and without malaria vaccination to reduce malaria burden in young children: a modelling analysis |
publisher |
BMC |
publishDate |
2023 |
url |
https://doi.org/10.1186/s12936-023-04564-9 https://doaj.org/article/d6640a93d961412981943992a6cc7333 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 22, Iss 1, Pp 1-13 (2023) |
op_relation |
https://doi.org/10.1186/s12936-023-04564-9 https://doaj.org/toc/1475-2875 doi:10.1186/s12936-023-04564-9 1475-2875 https://doaj.org/article/d6640a93d961412981943992a6cc7333 |
op_doi |
https://doi.org/10.1186/s12936-023-04564-9 |
container_title |
Malaria Journal |
container_volume |
22 |
container_issue |
1 |
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1768384118823845888 |