Project 06

Post-discharge malaria chemoprevention consortium

The PDMC Consortium composed of partners working together for over 10 years, has developed post-discharge malaria chemoprevention as a health strategy to reduce morbidity and mortality in children with severe anaemia which has now been adopted by WHO and recommended to be implemented in all countries where malaria is endemic. The Consortium continues to carry out research on optimizing this strategy and developing robust models for its delivery.

PDMC II

Combining monthly dihydroartemisinin-piperaquine and azithromycin for the post-discharge management of children with severe anaemia in Malawi, Kenya and Uganda.

Work Package 1: Clinical Trial

The main objective is to determine if four months of monthly PMC with the combination of DP+AZ is superior to PMC with DP-alone in reducing all-cause sick-child clinic visits (SCCV) by six months post-discharge in recently transfused children aged <5 years who are ready to be discharged, clinically stable and able to switch to oral medication.

Work Package 2: Acceptability and Feasibility studies

This is to determine the feasibility and acceptability from the health provider and patient/guardian perspective of PMC with DP plus AZ if it were to be integrated into the healthcare system in a typical LMIC.

Work Package 3: Economic study

The overall aim is to inform decision-makers whether PMC, as implemented in this trial, is likely to be cost-effective if routinely implemented relative to PMC with DP alone. The economic evaluation will provide information about incremental costs, incremental health benefits and cost-effectiveness.

Implement PDMC

Implementing Post-discharge Malaria Chemoprevention (PDMC) to reduce child mortality and morbidity among children with severe anaemia

We will use an innovative two-stage formative research approach to prospectively study the full- scale implementation of PDMC in Malawi. This interdisciplinary study will incorporate both provider and patient perspectives of the implementation at all levels of the care-continuum. PDMC is safe and efficacious, but with less convincing results regarding adherence. We shall study alternative approaches to implement PDMC exploring their costs, feasibility, acceptability, and breadth of coverage and uptake. This proposal combines observational and experimental approaches to maximize the potential impact and value.

Funding

EDCTP
Research Council of Norway

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