Traitement de pré-transfert et la létalité palustre dans la région sanitaire du Sahel de 2017 à 2019, Burkina Faso : analyse en série temporelle interrompue

Abstract

Title: Pre-referral treatment and malaria case fatality in the Sahel health region from 2017 to 2019, Burkina Faso: interrupted time series analysis.

Abstract

Introduction

We determined the effects of the pilot phase of pre-referral treatment of severe malaria cases in the Sahel health region, one with the highest malaria morbidity and mortality.

Materials and Methods:

A 36-month interrupted (uncontrolled) time-series analysis was applied to monthly malaria case-fatality data in children under 5 years of age from 2017 to 2019. Pre-transfer treatment of severe malaria cases in under-5s was introduced in October 2018. We used autoregressive and moving-average models with annual seasonality. The search for the best model was automatic through the auto.arima() function in the Forecast package of R. The immediate and long-term effects of pre-transfer treatment and their 95% confidence intervals were estimated.

Results

ASBCs referred 96.7% of cases (1452/1487) treated. Malaria case fatality was 1.6% in 2017, 1.2% in 2018 and 0.9% in 2019. The introduction of pre-transfer treatment had an immediate effect, with a reduction of 0.5%. Subsequently, an increase in case fatality of 0.04% per month was observed: 0.000435 (95% CI:-0.000234-0.00110). The implementation period coincided with increased security issues in the Sahel region.

Conclusion

Further study of the implementation process could help with potential extension.

Keywords: Malaria, pre-transfer treatment, artesunate suppository, lethality, Burkina Faso