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Integrating nutrition assessments and seasonal malaria chemoprevention
Results from a mixed-methods feasibility study in Guinea
Keita, M. S., Camara, A., Daffe, M., Fofana, A., Balde, M., Diallo, T., Barry, H., Fitch, E., Taton, J., Bangoura, L., Mbounga, E., & Reithinger, R. (2023). Integrating nutrition assessments and seasonal malaria chemoprevention: Results from a mixed-methods feasibility study in Guinea. Tropical Medicine and International Health, 28(7), 571-575. https://doi.org/10.1111/tmi.13897, https://doi.org/10.1111/tmi.v28.7
BACKGROUND: Seasonal malaria chemoprevention (SMC) has become a critical intervention for malaria prevention and control. There is a growing interest to generate evidence that health campaigns such as SMC can be leveraged for integration or co-administration of other health efforts such as nutritional supplements, immunizations, or vitamin A.
OBJECTIVE: We conducted a pilot study to assess whether nutrition assessments could be integrated into existing SMC programming in two districts in Guinea.
METHODS: Of 106,480 children under 5 years of age (CU5) who received sulfadoxine-pyrimethamine plus amodiaquine as part of SMC by community drug distributors (CDDs), 2210 had their mid-upper arm circumference (MUAC) assessed by CDD supervisors.
RESULTS: Of these, 177 (8.0%) had a MUAC < 125 mm and were therefore classified as acutely malnourished; 161 CU5 were referred to health facilities for follow-up. Importantly, no drop in SMC programmatic coverage was observed in districts conducting MUAC on top of SMC. Key informant interviews with district officials and focus group discussions with CDD supervisors showed a generally positive effect of integrating MUAC into SMC, although CDD supervisors had concerns about workload with added responsibilities of MUAC assessments.
CONCLUSION: Integrating other health interventions with SMC is accepted-and indeed welcomed-by the population and health workers, and does not result in a drop in SMC programmatic coverage.