Chemoprevention is an important method of disease prevention that involves the use of drugs to prevent the occurrence of illness. For malaria, Malaria Consortium focuses on chemoprevention strategies most appropriate for the settings in countries where we work. These strategies include seasonal malaria chemoprevention (SMC) for children under five and intermittent preventive treatment in pregnant women (IPTp).
In most parts of sub-Saharan Africa, where most malaria deaths occur, both pregnant women and young children are especially vulnerable to malaria. Other diseases can also sometimes be prevented through mass drug administration (MDA), which is the administration of drugs to entire populations for disease control and elimination. Examples of when MDAs are appropriate include the so-called neglected tropical diseases (NTDs): onchocerciasis, schistosomiasis, soil-transmitted helminths, lymphatic filariasis and trachoma. Malaria Consortium, in partnership with governments and communities, works to sensitise households on the benefits of these interventions, and has also conducted numerous drug distributions for NTDs.
Examples of our work
Malaria Consortium began providing SMC in Katsina and Jigawa states in Nigeria in 2013, which resulted in up to 70 percent reduction in reported malaria cases among under-fives in monitored health centres. This intervention has subsequently been scaled up to seven different countries in the Sahel region: Burkina Faso, Chad, Guinea, Mali, Niger, Nigeria and The Gambia through a UNITAID-funded project called ACCESS-SMC. The project will provide up to 30 million SMC treatments annually to 7.5 million children – potentially averting 49,000 deaths due to malaria.
IPTp involves the administration of repeated courses of antimalarial drugs to all pregnant women to help them avoid contracting malaria. Pregnant women should receive IPTp at each scheduled antenatal care (ANC) visit starting from the second trimester. Several studies have indicated that uptake of IPTp among pregnant women is often low for various reasons. In one of our studies in Uganda, for example, a main barrier was health worker knowledge of the IPTp provision guidelines, leading to missed opportunities for pregnant women attending ANC. To address this, we are currently implementing a small-scale pilot intervention which will assess if sending text messages to health workers is an effective way of increasing correct knowledge of the guidelines and therefore IPTp provision.
Our work in NTD chemoprevention supports large-scale integrated campaigns, which target diseases with the highest burdens. Our main focus lies in the delivery of safe and effective drugs to control several diseases: onchocerciasis, lymphatic filariasis, schistosomiasis, trachoma and soil-transmitted helminths. In South Sudan, working with the Ministry of Health, we helped design and implement integrated mapping and MDA campaigns for these diseases.
In Mozambique, we engage with local communities through community dialogues to talk about schistosomiasis and find relevant and culturally acceptable solutions. Alongside MDA campaigns, our operational and implementation research helped to inform the design of complementary control strategies, with the goal of adopting more holistic and sustainable approaches for NTD control in the long run.