BACKGROUND Seasonal malaria chemoprevention is widely implemented in Sahel and sub-Sahel countries in Africa. Few studies have assessed the impact of the SMC on hospital admission and death when it is implemented in the health system. This retrospective study assessed the impact of seasonal malaria chemoprevention (SMC) on hospitalizations and deaths of children under 5 years of age during the second year of implementation of SMC in the health district of Ouelessebougou in Mali. METHODS In February 2017, a survey was conducted to assess hospital admissions and deaths in children under 5 years of age in two health sub-districts where SMC was implemented in 2015 and two health sub-districts where SMC was not implemented. The survey reviewed deaths and hospitalizations of children under 5, in the four health sub-districts. The crude and specific incidence rates of hospitalizations and deaths were determined in both groups and expressed per 1000 children per year. A negative binomial regression model and a Cox model were used to estimate the relative risks of hospitalization and death after adjusting for confounders. The R software was used for data analysis. RESULTS A total of 6638 children under 5 years of age were surveyed, 2759 children in the SMC intervention areas and 3879 children in the control areas. All causes mortality rate per 1000 person-years was 8.29 in the control areas compared to 3.63 in the intervention areas; age and gender adjusted mortality rate ratio 0.44 (95% CI 0.22-0.91), p = 0.027. The incidence rate of all causes hospital admissions was 19.60 per 1000 person-years in the intervention group compared to 33.45 per 1000 person-years in the control group, giving an incidence rate ratio (IRR) adjusted for age and gender of 0.61 (95% CI 0.44-0.84), p = 0.003. CONCLUSION The implementation of SMC was associated with a substantial reduction in hospital admissions and all-cause mortality. Trial registration ClinicalTrials.gov NCT02646410.

中文翻译：

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马里Ouelessebougou，季节性化学预防疟疾对5岁以下儿童的住院和死亡率的影响。

背景技术季节性的疟疾化学预防在非洲的萨赫勒地区和撒哈拉以南国家广泛实施。很少有研究评估SMC在卫生系统中实施对住院和死亡的影响。这项回顾性研究评估了在马里Ouelessebougou卫生区实施SMC的第二年中，季节性疟疾化学预防（SMC）对5岁以下儿童的住院和死亡的影响。方法2017年2月，进行了一项调查，以评估2015年实施SMC的两个健康分区和未实施SMC的两个健康分区的5岁以下儿童的住院收治和死亡情况。该调查回顾了四个健康分区中5岁以下儿童的死亡和住院情况。两组均确定了住院和死亡的粗略和特定的发病率，并以每年每1000名儿童的数量表示。校正混杂因素后，使用负二项式回归模型和Cox模型来估计住院和死亡的相对风险。使用R软件进行数据分析。结果共调查了6638名5岁以下的儿童，SMC干预区的2759名儿童，对照区的3879名儿童。对照地区每千人年的所有原因死亡率为8.29，而干预地区为3.63；年龄和性别调整后的死亡率比率为0.44（95％CI 0.22-0.91），p = 0.027。干预组所有病因住院的发生率是每1000人年19.60，而33。对照组中每1000人年45，得出的年龄和性别调整后的发病率比（IRR）为0.61（95％CI 0.44-0.84），p = 0.003。结论SMC的实施与住院人数和全因死亡率的大幅降低有关。试用注册ClinicalTrials.gov NCT02646410。