A Stakeholder engagement meeting on the implementation of post-discharge malaria chemoprevention (PDMC) in Benin, Kenya, Malawi, and Uganda was held in Nairobi, Kenya, on 27 September 2023. Representatives from the respective National Malaria Control Programmes, the World Health Organization (WHO) Geneva, Africa Regional and Kenya offices, research partners, non-governmental organizations, and the Medicines for Malaria Venture participated. PDMC was recommended by the WHO in June 2022 and involves provision of a full anti-malarial treatment course at regular intervals during the post-discharge period in children hospitalized with severe anaemia in areas of moderate-to-high malaria transmission. The WHO recommendation followed evidence from a meta-analysis of three clinical trials and from acceptability, delivery, cost-effectiveness, and modelling studies. The trials were conducted in The Gambia using monthly sulfadoxine-pyrimethamine during the transmission season, in Malawi using monthly artemether-lumefantrine, and in Kenya and Uganda using monthly dihydroartemisinin-piperaquine, showing a significant reduction in all-cause mortality by 77% (95% CI 30–98) and a 55% (95% CI 44–64) reduction in all-cause hospital readmissions 6 months post-discharge. The recommendation has not yet been implemented in sub-Saharan Africa. There is no established platform for PDMC delivery. The objectives of the meeting were for the participating countries to share country contexts, plans and experiences regarding the adoption and implementation of PDMC and to explore potential delivery platforms in each setting. The meeting served as the beginning of stakeholder engagement within the PDMC Saves Lives project and will be followed by formative and implementation research to evaluate alternative delivery strategies in selected countries. Meeting highlights included country consensus on use of dihydroartemisinin-piperaquine for PDMC and expansion of the target group to "severe anaemia or severe malaria", in addition to identifying country-specific options for PDMC delivery for evaluation in implementation research. Further exploration is needed on whether the age group should be extended to school-age children.

中文翻译：

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在贝宁、肯尼亚、马拉维和乌干达实施出院后疟疾化学预防 (PDMC)：利益相关者参与会议报告

2023 年 9 月 27 日，在肯尼亚内罗毕举行了关于在贝宁、肯尼亚、马拉维和乌干达实施出院后疟疾化学预防 (PDMC) 的利益相关者参与会议。来自各自国家疟疾控制规划署、世界卫生组织的代表(世卫组织) 日内瓦、非洲区域和肯尼亚办事处、研究伙伴、非政府组织和疟疾药物项目参与其中。 PDMC 于 2022 年 6 月获得世界卫生组织推荐，涉及在中度至高度疟疾传播地区因严重贫血住院的儿童出院后定期提供完整的抗疟疾治疗课程。世卫组织的建议遵循了三项临床试验的荟萃分析以及可接受性、实施、成本效益和建模研究的证据。这些试验在冈比亚进行，在传播季节每月使用磺胺多辛-乙胺嘧啶，在马拉维使用每月蒿甲醚-本芴醇，在肯尼亚和乌干达每月使用双氢青蒿素-哌喹，结果显示全因死亡率显着降低了 77%（95 % CI 30–98)，出院后 6 个月全因再入院率减少 55% (95% CI 44–64)。该建议尚未在撒哈拉以南非洲实施。目前还没有建立 PDMC 交付平台。会议的目标是让与会国家分享有关采用和实施 PDMC 的国家背景、计划和经验，并探索各个环境中潜在的交付平台。此次会议是利益相关者参与 PDMC 拯救生命项目的开始，随后将进行形成性和实施研究，以评估选定国家的替代交付策略。会议亮点包括就使用双氢青蒿素-哌喹进行 PDMC 达成国家共识，以及将目标群体扩大到“严重贫血或严重疟疾”，此外还确定了针对具体国家的 PDMC 交付方案，以供实施研究中的评估。是否应将年龄组扩大到学龄儿童，还需要进一步探讨。