Sub-National Targeting of Seasonal Malaria Chemoprevention in the Sahelian Countries of the Nouakchott Initiative
Sub-National Targeting of Seasonal Malaria Chemoprevention in the Sahelian Countries of the Nouakchott Initiative
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DOI：
10.1371/journal.pone.0136919
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发表时间：
2015-08-31
期刊：
影响因子：
3.7
通讯作者：
Snow, Robert W.
中科院分区：
文献类型：
--
作者：
Noor, Abdisalan Mohamed;Kibuchi, Eliud;Snow, Robert W.
背景 季节性疟疾化学预防（SMC）已被证明在传播季节性严重的地区对临床疟疾非常有效。 SMC 的目标取决于气候、疟疾传播和人口分布之间复杂的相互作用。在这项研究中，开发了一个空间决策支持框架，以确定适合努瓦克肖特倡议成员的七个萨赫勒国家和尼日利亚北部各州的 SMC 目标卫生区。方法开发了一个空间明确的决策支持框架，该框架将季节性、年龄结构人口、城市化、疟疾流行和传播季节长度等信息联系起来，以便为卫生区的 SMC 目标提供信息。定义了季节性、人口和接受风险的阈值，以划定 SMC 合适的卫生区并确定目标儿童的年龄范围。然后计算 SMC 地区 2015 年至 2020 年期间的儿童人数。 2015 年，这与疟疾传播季节长度地图和 WHO 推荐的治疗方案相结合，以量化 SMC 卫生区所需的药片数量。 结果 共绘制了 597 个萨赫勒卫生区地图，其中 478 个 (80.1%) 根据季节性和流行阈值被认为适合 SMC。 2015 年，这些地区的人口估计为 1.198 亿（85%）。从 2015 年到 2020 年的六年里，估计共有 1.58 亿儿童（300 岁到 20 岁）
BackgroundSeasonal malaria chemoprevention (SMC) has been shown to be highly efficacious against clinical malaria in areas where transmission is acutely seasonal. SMC targeting depends on a complex interplay of climate, malaria transmission and population distribution. In this study a spatial decision support framework was developed to identify health districts suitable for the targeting of SMC across seven Sahelian countries and northern states of Nigeria that are members of the Nouakchott Initiative.MethodsA spatially explicit decision support framework that links information on seasonality, age-structured population, urbanization, malaria endemicity and the length of transmission season was developed to inform SMC targeting in health districts. Thresholds of seasonality, population and receptive risks were defined to delineate SMC suitable health districts and define the age range of children for targeting. Numbers of children were then computed for the period 2015-2020 in SMC districts. For 2015, this was combined with maps of length of malaria transmission seasons and WHO recommended treatment regimen to quantify the number of tablets required across the SMC health districts.ResultsA total of 597 Sahelian health districts were mapped, out of which 478 (80.1%) were considered suitable for SMC based on seasonality and endemicity thresholds. These districts had an estimated 119.8 million (85%) of the total population in 2015. In the six years from 20152020, it is estimated that a total of 158 million children 3m to