Assessment of a Combined Strategy of SMC + Nutrients Supplementation to Tackle Malaria and Malnutrition

Summary

Malaria and malnutrition represent major public health concerns worldwide especially in Sub-Sahara Africa. Despite implementation of Seasonal Malaria Chemoprophylaxis (SMC), an intervention aimed at reducing malaria prevalence among children aged 6- 59 months, the burden of malaria and associated mortality among children below age 5 years remains high in Burkina Faso. This raises the question of what hiding factors may negatively affect the responsiveness of SMC intervention. Malnutrition, in particular micronutrient deficiency, is one of these potential factors that can negatively affect the effectiveness of SMC. Treating micronutrient deficiencies is known to reduce the prevalence of malaria mortality in highly prevalent malaria zone such as rural settings. Therefore, the hypothesis that a combined strategy of SMC together with a daily oral nutrients supplement (Vitamin A-Zinc OR fortified peanut butter-like paste-Plumpy'Doz) will enhance the immune response and decrease the incidence of malaria in this population and at the same time reduce the burden of malnutrition among children under SMC coverage was postulated. Prior to the SMC implementation by the National Malaria Control Program (NMCP), children under SMC coverage will be identified through the Health and Demographic Surveillance System (HDSS). Children will be randomly assigned to one of the three groups (a) SMC + Vitamin A alone, (b) SMC + Vitamin A+ Zinc, or (c) SMC+Vitamin A + Plumpy'Doz. After each SMC monthly distribution, children will be visited at home to confirm drug administration and follow-up for one year. Anthropometric indicators will be recorded at each visit. Blood samples will be collected for thick and thin film and hemoglobin measurement and spotted onto filter paper for further PCR analyses. This project will serve as a pilot of an integrated strategy in order to mutualize resources for best impact. By relying on existing strategies, the policy implementation of this joint intervention will be scalable at country and regional levels.

Timeline

Start

2020-07-13

Primary completion

2021-07-04

Completion

2022-03

Publications

• Sondo P, Kabore B, Rouamba T, Compaore E, Tibiri YNG, Kabore HALF, Derra K, Tahita MC, Ilboudo H, Tougri G, Bouda I, Dakyo T, Kafando H, Ouedraogo F, Rouamba E, Hien SF, Kazienga A, Compaore CS, Bambara E, Nana M, Dahal P, Garanet F, Kabore W, Lefevre T, Guerin P, Tinto H. Enhanced effect of seasonal malaria chemoprevention when coupled with nutrients supplementation for preventing malaria in children under 5 years old in Burkina Faso: a randomized open label trial. Malar J. 2023 Oct 18;22(1):315. doi: 10.1186/s12936-023-04745-6.
• Sondo P, Tahita MC, Rouamba T, Derra K, Kabore B, Compaore CS, Ouedraogo F, Rouamba E, Ilboudo H, Bambara EA, Nana M, Sawadogo EY, Sorgho H, Some AM, Valea I, Dahal P, Traore/Coulibaly M, Tinto H. Assessment of a combined strategy of seasonal malaria chemoprevention and supplementation with vitamin A, zinc and Plumpy'Doz to prevent malaria and malnutrition in children under 5 years old in Burkina Faso: a randomized open-label trial (SMC-NUT). Trials. 2021 May 24;22(1):360. doi: 10.1186/s13063-021-05320-7.

Drugs

Indications