EDCTP Alumni Network

Fostering excellence and collaboration in the next generation of researchers

Call Senior Fellowship (SF)
Programme EDCTP1
Start Date 2011-04-11
End Date 2013-04-10
Project Code TA.2010.40200.032
Status Completed

Title

Intermittent preventive treatment in children combined with malaria home management in an area with persisting high malaria prevalence in Senegal

Objectives

To determine whether seasonal IPTc with sulfadoxine-pyrimethamine plus amodiaquine provide added benefit in populations with access to prompt effective treatment through home–based management; whether IPTc has previously been shown effective when give for three months in areas with a short transmission season and whether seasonal IPTc is safe and acceptable when given for a longer period in areas with a longer transmission season. To also show the cost-effectiveness of adding seasonal IPTc to home management of malaria (HMM)

Host Organisation

Institution Country
University Cheikh Anta Diop of Dakar Senegal
University of Thies Senegal

Participants

Name Institution Country
Jean louis Abdourahim Ndiaye University Cheikh Anta DIOP de Dakar (UCAD) Senegal
Paul Milligan London School of Hygiene and Tropical Medicina (LSHTM) United Kingdom
Youssoupha Ndiaye Ministere de la sante et de la prevetion medicale, Senegal Senegal
Pape Moussa Thior Ministere de la sante et de la prevention medicale Senegal

Study Design

Phase III: Cluster randomised trial

Sites

Saraya, south Senegal

Phd Study

Title University Start Date End Date
Clinical and biological response and genetic diversity of Plasmodium falciparum during uncomplicated malaria episodes treated with ACTs in rural areas in Senegal UCAD 2008-01-12 2011-07-12

Students Supervised

Type Name Title University Start Date End Date
MSc in Parasitology Mamadou Sarifou Ba Dr UCAD 2011 2013

Results & Outcomes

Twenty four community health workers and malaria volunteers were trained by the Department of Parasitology to do thick and thin blood smear to confirm all malaria cases in the 24 villages involved in the project.

Publications

Ndiaye JLA, Ndiaye Y, Ba MS, Faye B, Ndiaye M, Seck A, et al. (2019) Seasonal malaria chemoprevention combined with community case management of malaria in children under 10 years of age, over 5 months, in south-east Senegal: A cluster-randomised trial. PLoS Med 16(3): e1002762. https://doi.org/10.1371/journal.pmed.1002762

Current Organisation

University of Thies, Senegal

Current Job Title

Head of departement of Medical Biology

Awards

2013 Wellcome Intermediate fellowship in Public Health and tropical medecine

Memberships

Role Committee/board Start Date End Date
communication secretariat African Society of Parasitologie 2016
Editorial board member African Journal of Medical Biology 2016

Education

Institution Degree Year
University Cheikh Anta Diop, Senegal MD 1998
University Cheikh Anta Diop, Senegal PhD 2011
Unversity Cheikh Anta Diop, Senegal MSC 2006

Areas Of Specialisation

parasitology malaria

Grants

Grant Code:
2015/550233-0
Source of funding:
WHO-TDR
Amount:
87500
Role:
Principal Investigator
Start Date:
2015-08-25
End Date:
2015-12-24
Grant Code:
Source of funding:
Wellcome Trust
Amount:
496983.796
Role:
Principal Investigator
Start Date:
2013-07-12
End Date:
2018-07-12

Publications

Authors:
Jean Louis A. Ndiaye , Youssoupha Ndiaye, Mamadou S. Ba, Babacar Faye, Maguette Ndiaye, Amadou Seck, Roger Tine, Pape Moussa Thior, Sharanjeet Atwal, Khalid Beshir, Colin Sutherland, Oumar Gaye, Paul Milligan , Ndiaye JLA, Ndiaye Y, Ba MS, Faye B, Ndiaye M, Seck A, et al. (2019) Seasonal malaria chemoprevention combined with community case management of malaria in children under 10 years of age, over 5 months, in south-east Senegal: A cluster-randomised trial. PLoS Med 16(3): e1002762. https://doi.org/10.1371/journal.pmed.1002762
Date:
2019-03-13
Journal:
Plos Medicine
Content:

Background

Seasonal malaria chemoprevention (SMC) is recommended in the Sahel region of Africa for children under 5 years of age, for up to 4 months of the year. It may be appropriate to include older children and to provide protection for more than 4 months. We evaluated the effectiveness of SMC using sulfadoxine-pyrimethamine plus amodiaquine given over 5 months to children under 10 years of age in Saraya district in south-east Senegal in 2011.

Methods and findings

Twenty-four villages, including 2,301 children aged 3–59 months and 2,245 aged 5–9 years, were randomised to receive SMC with community case management (CCM) (SMC villages) or CCM alone (control villages). In all villages, community health workers (CHWs) were trained to treat malaria cases with artemisinin combination therapy after testing with a rapid diagnostic test (RDT). In SMC villages, CHWs administered SMC to children aged 3 months to 9 years once a month for 5 months. The study was conducted from 27 July to 31 December 2011. The primary outcome was malaria (fever or history of fever with a positive RDT). The prevalence of anaemia and parasitaemia was measured in a survey at the end of the transmission season. Molecular markers associated with resistance to SMC drugs were analysed in samples from incident malaria cases and from children with parasitaemia in the survey. SMC was well tolerated with no serious adverse reactions. There were 1,472 RDT-confirmed malaria cases in the control villages and 270 in the SMC villages. Among children under 5 years of age, the rate difference was 110.8/1,000/month (95% CI 64.7, 156.8; p < 0.001) and among children 5–9 years of age, 101.3/1,000/month (95% CI 66.7, 136.0; p < 0.001). The mean haemoglobin concentration at the end of the transmission season was higher in SMC than control villages, by 6.5 g/l (95% CI 2.0, 11; p = 0.007) among children under 5 years of age, and by 5.2 g/l (95% CI 0.4, 9.9; p = 0.035) among children 5–9 years of age. The prevalence of parasitaemia was 18% in children under 5 years of age and 25% in children 5–9 years of age in the control villages, and 5.7% and 5.8%, respectively, in these 2 age groups in the SMC villages, with prevalence differences of 12.5% (95% CI 6.8%, 18.2%; p < 0.001) in children under 5 years of age and 19.3% (95% CI 8.3%, 30.2%; p < 0.001) in children 5–9 years of age. The pfdhps-540E mutation associated with clinical resistance to sulfadoxine-pyrimethamine was found in 0.8% of samples from malaria cases but not in the final survey. Twelve children died in the control group and 14 in the SMC group, a rate difference of 0.096/1,000 child-months (95% CI 0.99, 1.18; p =0.895). Limitations of this study include that we were not able to obtain blood smears for microscopy for all suspected malaria cases, such that we had to rely on RDTs for confirmation, which may have included false positives.

Conclusions

In this study, SMC for children under 10 years of age given over 5 months was feasible, well tolerated, and effective in preventing malaria episodes, and reduced the prevalence of parasitaemia and anaemia. SMC with CCM achieved high coverage and ensured children with malaria were promptly treated with artemether-lumefantrine.

Identifiers:
Authors:
NDiaye JL, Cissé B, Ba EH, Gomis JF, Ndour CT, Molez JF, Fall FB, Sokhna C, Faye B, Kouevijdin E, Niane FK, Cairns M, Trape JF, Rogier C, Gaye O, Greenwood BM, Milligan PJ. , PLoS One. 2016 Dec 8;11(12):e0168421. doi: 10.1371/journal.pone.0168421. eCollection 2016.
Date:
2016-10-20
Journal:
Plos One
Content:

BACKGROUND: 

It is recommended that children aged 3 months to five years of age living in areas of seasonal transmission in the sub-Sahel should receive Seasonal Malaria Chemoprevention (SMC) with sulfadoxine-pyrimethamine plus amodiaquine (SPAQ) during the malaria transmission season. The purpose of this study was to evaluate the safety of SMC with SPAQ in children when delivered by community health workers in three districts in Senegal where SMC was introduced over three years, in children from 3 months of age to five years of age in the first year, then in children up to 10 years of age.

METHODS: 

A surveillance system was established to record all deaths and all malaria cases diagnosed at health facilities and a pharmacovigilance system was established to detect adverse drug reactions. Health posts were randomized to introduce SMC in a stepped wedge design. SMC with SPAQ was administered once per month from September to November, by nine health-posts in 2008, by 27 in 2009 and by 45 in 2010.

RESULTS: 

After three years, 780,000 documented courses of SMC had been administered. High coverage was achieved. No serious adverse events attributable to the intervention were detected, despite a high level of surveillance.

CONCLUSIONS: 

SMC is being implemented in countries of the sub-Sahel for children under 5 years of age, but in some areas the age distribution of cases of malaria may justify extending this age limit, as has been done in Senegal. Our results show that SMC is well tolerated in children under five and in older children. However, pharmacovigilance should be maintained where SMC is implemented and provision for strengthening national pharmacovigilance systems should be included in plans for SMC implementation.

Identifiers:
Authors:
Ndiaye J-L A., Diallo I, Ndiaye Y, Kouevidjin E, Aw I, Tairou F, Ndoye t, Halleux CM, Manga I, Dieme MN, Ndiop M, Faye B, Olliaro P, Merle CS, Gaye O, Milligan P. , DOI: 10.1007/s40290-018-0232-z
Date:
2018-06-01
Journal:
Pharmaceut Med. 2018;32(3):189-200
Content:

BACKGROUND : Seasonal malaria chemoprevention (SMC) using sulfadoxine-pyrimethamine plus amodiaquine has been introduced in 12 African countries. Additional strategies for safety monitoring are needed to supplement national systems of spontaneous reporting that are known to under represent the incidence of adverse reactions.

OBJECTIVES: 

This study aimed to determine if adverse event (AE) reporting could be improved using a smartphone application provided to village health workers, or by active follow-up using a symptom card provided to caregivers.

METHODS: 

Two strategies to improve reporting of AEs during SMC campaigns were evaluated, in comparison with the national system of spontaneous reporting, in 11 health post areas in Senegal. In each health post, an average of approximately 4000 children under 10 years of age received SMC treatment each month for 3 months during the 2015 malaria transmission season-a total of 134,000 treatments. In three health posts (serving approximately 14,000 children), caregivers were encouraged to report any adverse reactions to the nurse at the health post or to a community health worker (CHW) in their village, who had been trained to use a smartphone application to report the event (enhanced spontaneous reporting). In two health posts (approximately 10,000 children), active follow-up of children at home was organized after each SMC campaign to ask about AEs that caregivers had been asked to record on a symptom card (active surveillance). Six health posts (approximately 23,000 children) followed the national system of spontaneous reporting using the national reporting (yellow) form. Each AE report was assessed by a panel to determine likely association with SMC drugs.

RESULTS: 

The incidence of reported AEs was 2.4, 30.6, and 21.6 per 1000 children treated per month, using the national system, enhanced spontaneous reporting, and active surveillance, respectively. The most commonly reported symptoms were vomiting, fever, and abdominal pain. The incidence of vomiting, known to be caused by amodiaquine, was similar using both innovative methods (10/1000 in the first month, decreasing to 2.5/1000 in the third month). Despite increased surveillance, no serious adverse drug reactions were detected.

CONCLUSION: 

Training CHWs in each village and health facility staff to report AEs using a mobile phone application led to much higher reporting rates than through the national system. This approach is feasible and acceptable, and could be further improved by strengthening laboratory investigation and the collection of control data immediately prior to SMC campaigns.

Identifiers:

Projects

Fellow:
Jean Louis Abdourahim Ndiaye
Collaborators:
Name Country Institution
Jean Louis Ndiaye Senegal University of Thies
Objectives:
to assess the quality of schoolchildren's awareness of malaria with the MOSKI-KIT tool
Sites:
Dakar
Study Design:
quantitative and qualitative surveys
Subjects:
school children of 3 primary schools in Dakar
Start Date:
2017-11-01
End Date:
2019-06-30

Send a Message