Using Seasonal Malaria Chemoprevention (SMC) to Screen for Acute Malnutrition

Moumouni Bonkoungou, Ousmane Badolo, Youssouf Sawadogo, Stanislas Nebie, Thierry Ouedraogo, Yacouba Savadogo, William Brieger, Gladys Tetteh, and Blami Dao (affiliation PMI Improving Malaria Care Project; Jhpiego Baltimore; Johns Hopkins University; Ministry of Health, National Malaria Control Program) presented a poster entitled Using Seasonal Malaria Chemoprevention (SMC) to Screen for Acute Malnutrition at the 68th Annual Meeting of the American Society of Tropical Medicine and Hygiene. Their findings are outlined below.

Malaria and malnutrition remain major public health burdens in Burkina Faso for children under five years of age. In 2017 the case fatality rate of malaria was 1.5 percent among children under five years of age and malaria was responsible for 35.9 percent of deaths in primary health facilities. Malnutrition was responsible for 4.6 percent of deaths in primary health facilities and 3.3 percent of deaths in hospitals in 2017.

What is IMC project? The US President’s Malaria Initiative (PMI) funded the Improving malaria Care (IMC) since 2013 to support National Malaria Control Program (NMCP). The goal is to improve quality of malaria prevention, diagnosis and treatment through 05 strategies.

Malnutrition was detected at the level of health facilities. The nutrition program did not have resources for active screening for malnutrition Since 2018, it has been decided on the couple with the SMC to recruit more children.

What is the strategy? In 2018, Burkina Faso Seasonal Malaria Chemoprevention (SMC) campaign integrated malnutrition screening in 12 health districts supported by IMC. During the SMC campaign, community health workers administer sulfadoxine-pyrimethamine + amodiaquine (SP+AQ).

They also screened for malnutrition using the Shakir sling to measure mid-upper arm circumference to detect for acute malnutrition. Children who are not severely malnourished receive the standard malaria preventative treatment by SP+AQ. Children diagnosed with severe malnutrition do not receive SP+AQ and are referred to health facilities for appropriate case management.

Moderate and severe malnutrition was documented in October 2019. In November, after the last round (October), 427 children with severe acute malnutrition have been reported by health facilities. 81.3 percent of severe acute malnutrition detected during SMC.

Challenges of SMC and malnutrition screening were documented as follows:

  • Inaccessibility of some areas
  • Reference of severe cases for management
  • Adequate home management of moderate cases
  • Proper care of referred children in health facilities
  • Follow-up of referrals
  • Search for those not followed-up

In Conclusion in the context of a limited resource country, SMC is a good strategy for the reduction of malaria cases as well as a great opportunity for the detection and management of malnutrition in children under five years of age. It is recommended to Couple the screening of malnutrition with other activities (immunization, distribution of bednets …). Raising parents’ awareness of the importance of managing cases is necessary as is Encouraging active case finding and community referral.

This poster was made possible by the generous support of the American people through the United States Agency for International Development (USAID) under Cooperative Agreement No. AID-624-A-13-00010 and the President’s Malaria Initiative (PMI). The contents are the responsibility of the authors and do not necessarily reflect the views of USAID, PMI or the United States Government.

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