Combating severe malaria in African children

Area of Science:

• Global Health
• Infectious Diseases
• Public Health Interventions

Background:

• The Africa Child Survival Initiative-Combatting Childhood Communicable Diseases (CCCD) project, established in 1982, operates in 13 African countries, with 12 being malaria-endemic.
• The project aims to reduce childhood mortality from malaria, diarrhea, and vaccine-preventable diseases.
• Malaria control strategies focus on drug use (primarily chloroquine) for children under five and chemoprophylaxis for pregnant women, aligning with WHO recommendations.

Purpose of the Study:

• To assess the sensitivity of Plasmodium falciparum to chloroquine in children across CCCD countries.
• To evaluate current malaria treatment practices and identify areas for improvement.
• To strengthen malaria control units and integrate interventions into primary healthcare.

Main Methods:

• Drug sensitivity surveillance of Plasmodium falciparum to chloroquine was conducted in 9 of the 13 CCCD countries.
• Baseline surveys were performed in 6 countries to document existing treatment practices.
• The establishment and development of malaria control units and national malaria control plans were tracked.

Main Results:

• In areas with chloroquine-resistant P. falciparum, chloroquine treatment still reduced fever and parasite density in children, preventing severe illness.
• Baseline surveys revealed varied treatment practices, including inconsistent dosing and overuse of injections.
• Research into alternative drug treatments for pregnant women was initiated due to low chemoprophylaxis uptake.
• Malaria control units increased from 4 to 11 in malarious countries, with integrated national malaria control plans developed.

Conclusions:

• The CCCD project has successfully enhanced malaria control infrastructure and strategies in participating African nations.
• Integration of malaria control into primary healthcare and standardized treatment plans have been achieved.
• Despite challenges like drug resistance and varied practices, the initiative demonstrates progress in reducing malaria's impact on child survival.