Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial

Yanogo Pauline Kiswendsida; Sanou Estelle Nadine; Isidore Tiandiogo Traore; Yanogo Chantal; Halidou Tinto

doi:doi:10.11648/j.sjph.20251304.12

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Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial

Yanogo Pauline Kiswendsida^*

, Sanou Estelle Nadine

, Isidore Tiandiogo Traore

, Yanogo Chantal

, Halidou Tinto

Published in Science Journal of Public Health (Volume 13, Issue 4)

Received: 28 May 2025 Accepted: 15 July 2025 Published: 16 July 2025

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Abstract

The implementation of seasonal malaria chemoprevention (SMC) in Burkina Faso has not achieved its objective of reducing by at least 60% the morbidity associated with malaria in children under 5 years of age. We assessed a new approach of delivery consisting for the community health workers to directly supervise the three doses of the treatment compared to the standard of delivery (only the first dose directly observed treatment). The objective of the study was to compare the superiority of three doses supervised intake of SMC (3DOT) to the supervised intake of the first dose only. Three centers for health and social promotion were randomly selected in the Gaoua health district (3DOT) and 4 in the Boromo health district (1DOT) to receive a monthly four rounds of SMC with Sulfadoxine-pyrimethamine plus Amodiaquine (SP+AQ) in a quasi-experimental cluster randomized trial, before-after with a control group design which included in total 2440 children. The primary endpoint was the reduction in prevalence between each SMC round. The Khi-2 test was used to assess the superiority of 3DOT versus 1DOT. The reduction of malaria prevalence was significantly higher in 3DOT compared to the 1DOT, 68.60% vs 53.00% (p<.0001). The coverage in the 3DOT was significantly lower than that in the 1DOT, 81.39% versus 95.72%; p<0.0001 for optimal coverage. The 3DOT delivery approach of SMC provides better reduction of malaria prevalence than the 1DOT. However, the lower coverage obtained with the 3DOT compared to the 1DOT is a concerning issue to overcome in the perspective of the scale-up of this strategy at large scale.

Published in	Science Journal of Public Health (Volume 13, Issue 4)
DOI	10.11648/j.sjph.20251304.12
Page(s)	177-188
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

SMC, Method of Delivery, 3DOT, Burkina Faso

References

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[3]	Konaté AT, Yaro JB, Ouédraogo AZ, et al. Intermittent preventive treatment of malaria provides substantial protection against malaria in children already protected by an insecticide-treated bednet in Burkina Faso: a randomised, double-blind, placebo-controlled trial. PLoS Med. 2011; 8(2): e1000408. https://doi.org/10.1371/journal.pmed.1000408
[4]	Meremikwu MM, Donegan S, Sinclair D, Esu E, Oringanje C. Intermittent preventive treatment for malaria in children living in areas with seasonal transmission. Cochrane Database Syst Rev. 2012; (2): CD003756. https://doi.org/10.1002/14651858.CD003756.pub4
[5]	Compaoré R, Yameogo MWE, Millogo T, Tougri H, Kouanda S. Evaluation of the implementation fidelity of the seasonal malaria chemoprevention intervention in Kaya health district, Burkina Faso. PLOS ONE. 2017; 12(11): e0187460. https://doi.org/10.1371/journal.pone.0187460
[6]	Souares A, Lalou R, Sene I, Sow D, Le Hesran JY. Factors related to compliance to anti-malarial drug combination: example of amodiaquine/sulphadoxine-pyrimethamine among children in rural Senegal. Malar J. 2009; 8: 118. https://doi.org/10.1186/1475-2875-8-118
[7]	Tiono AB, Kangoye DT, Rehman AM, et al. Malaria incidence in children in South-West Burkina Faso: comparison of active and passive case detection methods. PLoS One. 2014; 9(1): e86936. https://doi.org/10.1371/journal.pone.0086936
[8]	Ministère de la Santé et de l’Hygiène publique Burkina. Annuaire statistique 2020. https://www.sante.gov.bf/fileadmin/user_upload/storages/annuaire_statistique_ms_2020_signe.pdf 2020. Accessed February 27, 2024.
[9]	Yanogo PK, Yanogo C, Tinto H. Prevalence of Malaria among Children between 3 and 59 Months Old in Two Healthcare Districts of Burkina Faso, 2020. TIJPH. 2024; 12(04). https://doi.org/10.21522/TIJPH.2013.12.04.Art001
[10]	Hayes RJ, Bennett S. Simple sample size calculation for cluster-randomized trials. International Journal of Epidemiology. 1999; 28(2): 319-326. https://doi.org/10.1093/ije/28.2.319
[11]	Cairns M, Ceesay SJ, Sagara I, et al. Effectiveness of seasonal malaria chemoprevention (SMC) treatments when SMC is implemented at scale: Case-control studies in 5 countries. PLoS Med. 2021; 18(9): e1003727. https://doi.org/10.1371/journal.pmed.1003727
[12]	Adjei MR, Kubio C, Buamah M, et al. Effectiveness of seasonal malaria chemoprevention in reducing under-five malaria morbidity and mortality in the Savannah Region, Ghana. Ghana Med J. 2022; 56(2): 64-70. https://doi.org/10.4314/gmj.v56i2.2
[13]	Kirakoya-Samadoulougou F, De Brouwere V, Fokam AF, Ouédraogo M, Yé Y. Assessing the effect of seasonal malaria chemoprevention on malaria burden among children under 5 years in Burkina Faso. Malar J. 2022; 21(1): 143. https://doi.org/10.1186/s12936-022-04172-z
[14]	Kweku M, Webster J, Adjuik M, Abudey S, Greenwood B, Chandramohan D. Options for the delivery of intermittent preventive treatment for malaria to children: a community randomised trial. PLoS One. 2009; 4(9): e7256. https://doi.org/10.1371/journal.pone.0007256
[15]	Bojang KA, Akor F, Conteh L, et al. Two strategies for the delivery of IPTc in an area of seasonal malaria transmission in the Gambia: a randomised controlled trial. PLoS Med. 2011; 8(2): e1000409. https://doi.org/10.1371/journal.pmed.1000409
[16]	Barry A, Issiaka D, Traore T, et al. Optimal mode for delivery of seasonal malaria chemoprevention in Ouelessebougou, Mali: A cluster randomized trial. PLoS One. 2018; 13(3): e0193296. https://doi.org/10.1371/journal.pone.0193296
[17]	Dabiré KR, Diabaté A, Namontougou M, et al. Distribution of insensitive acetylcholinesterase (ace-1R) in Anopheles gambiae s.l. populations from Burkina Faso (West Africa). Trop Med Int Health. 2009; 14(4): 396-403. https://doi.org/10.1111/j.1365-3156.2009.02243.x
[18]	Hancock PA, Hendriks CJM, Tangena JA, et al. Mapping trends in insecticide resistance phenotypes in African malaria vectors. PLoS Biol. 2020; 18(6): e3000633. https://doi.org/10.1371/journal.pbio.3000633
[19]	Malaria Consortium. Coverage and quality of seasonal malaria chemoprevention supported by Malaria Consortium with philanthropic funding or cofunding in 2023: Results from Burkina Faso, Chad, Mozambique, Nigeria, South Sudan, Togo and Uganda. https://www.malariaconsortium.org/media-download-file/202404250547/2023malariaconsortiumsmccoveragereport.pdf Accessed May 11, 2025.

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APA Style

Kiswendsida, Y. P., Nadine, S. E., Traore, I. T., Chantal, Y., Tinto, H. (2025). Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial. Science Journal of Public Health, 13(4), 177-188. https://doi.org/10.11648/j.sjph.20251304.12

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ACS Style

Kiswendsida, Y. P.; Nadine, S. E.; Traore, I. T.; Chantal, Y.; Tinto, H. Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial. Sci. J. Public Health 2025, 13(4), 177-188. doi: 10.11648/j.sjph.20251304.12

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AMA Style

Kiswendsida YP, Nadine SE, Traore IT, Chantal Y, Tinto H. Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial. Sci J Public Health. 2025;13(4):177-188. doi: 10.11648/j.sjph.20251304.12

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@article{10.11648/j.sjph.20251304.12,
  author = {Yanogo Pauline Kiswendsida and Sanou Estelle Nadine and Isidore Tiandiogo Traore and Yanogo Chantal and Halidou Tinto},
  title = {Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial
},
  journal = {Science Journal of Public Health},
  volume = {13},
  number = {4},
  pages = {177-188},
  doi = {10.11648/j.sjph.20251304.12},
  url = {https://doi.org/10.11648/j.sjph.20251304.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20251304.12},
  abstract = {The implementation of seasonal malaria chemoprevention (SMC) in Burkina Faso has not achieved its objective of reducing by at least 60% the morbidity associated with malaria in children under 5 years of age. We assessed a new approach of delivery consisting for the community health workers to directly supervise the three doses of the treatment compared to the standard of delivery (only the first dose directly observed treatment). The objective of the study was to compare the superiority of three doses supervised intake of SMC (3DOT) to the supervised intake of the first dose only. Three centers for health and social promotion were randomly selected in the Gaoua health district (3DOT) and 4 in the Boromo health district (1DOT) to receive a monthly four rounds of SMC with Sulfadoxine-pyrimethamine plus Amodiaquine (SP+AQ) in a quasi-experimental cluster randomized trial, before-after with a control group design which included in total 2440 children. The primary endpoint was the reduction in prevalence between each SMC round. The Khi-2 test was used to assess the superiority of 3DOT versus 1DOT. The reduction of malaria prevalence was significantly higher in 3DOT compared to the 1DOT, 68.60% vs 53.00% (p<.0001). The coverage in the 3DOT was significantly lower than that in the 1DOT, 81.39% versus 95.72%; p<0.0001 for optimal coverage. The 3DOT delivery approach of SMC provides better reduction of malaria prevalence than the 1DOT. However, the lower coverage obtained with the 3DOT compared to the 1DOT is a concerning issue to overcome in the perspective of the scale-up of this strategy at large scale.},
 year = {2025}
}

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TY  - JOUR
T1  - Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial

AU  - Yanogo Pauline Kiswendsida
AU  - Sanou Estelle Nadine
AU  - Isidore Tiandiogo Traore
AU  - Yanogo Chantal
AU  - Halidou Tinto
Y1  - 2025/07/16
PY  - 2025
N1  - https://doi.org/10.11648/j.sjph.20251304.12
DO  - 10.11648/j.sjph.20251304.12
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 177
EP  - 188
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20251304.12
AB  - The implementation of seasonal malaria chemoprevention (SMC) in Burkina Faso has not achieved its objective of reducing by at least 60% the morbidity associated with malaria in children under 5 years of age. We assessed a new approach of delivery consisting for the community health workers to directly supervise the three doses of the treatment compared to the standard of delivery (only the first dose directly observed treatment). The objective of the study was to compare the superiority of three doses supervised intake of SMC (3DOT) to the supervised intake of the first dose only. Three centers for health and social promotion were randomly selected in the Gaoua health district (3DOT) and 4 in the Boromo health district (1DOT) to receive a monthly four rounds of SMC with Sulfadoxine-pyrimethamine plus Amodiaquine (SP+AQ) in a quasi-experimental cluster randomized trial, before-after with a control group design which included in total 2440 children. The primary endpoint was the reduction in prevalence between each SMC round. The Khi-2 test was used to assess the superiority of 3DOT versus 1DOT. The reduction of malaria prevalence was significantly higher in 3DOT compared to the 1DOT, 68.60% vs 53.00% (p<.0001). The coverage in the 3DOT was significantly lower than that in the 1DOT, 81.39% versus 95.72%; p<0.0001 for optimal coverage. The 3DOT delivery approach of SMC provides better reduction of malaria prevalence than the 1DOT. However, the lower coverage obtained with the 3DOT compared to the 1DOT is a concerning issue to overcome in the perspective of the scale-up of this strategy at large scale.
VL  - 13
IS  - 4
ER  -

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Author Information

Yanogo Pauline Kiswendsida

Department of Public Health, Health Science Research and Training Unit, Joseph Ki-Zerbo University, Ouagadougou, Burkina Faso. Burkina Field Epidemiology and Laboratory Training Program (BFELTP), Health Science Research and Training Unit, Joseph Ki-Zerbo University, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso

Contact Email

http://orcid.org/0000-0001-5810-3449
Sanou Estelle Nadine

Burkina Field Epidemiology and Laboratory Training Program (BFELTP), Health Science Research and Training Unit, Joseph Ki-Zerbo University, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso

Contact Email

http://orcid.org/0000-0001-5030-4684
Isidore Tiandiogo Traore

Higher Institute of Health Sciences, University Nazi BONI, Bobo-Dioulasso, Burkina Faso

http://orcid.org/0000-0003-1135-5715
Yanogo Chantal

Burkina Field Epidemiology and Laboratory Training Program (BFELTP), Health Science Research and Training Unit, Joseph Ki-Zerbo University, Université Joseph Ki-Zerbo, Ouagadougou, Burkina Faso

Contact Email

http://orcid.org/0009-0006-3722-5205
Halidou Tinto

Clinical Research Unit of Nanoro, Institut de Recherche en Sciences de la Santé, Nanoro, Burkina Faso

Contact Email

http://orcid.org/0000-0002-0472-3586

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APA Style

Kiswendsida, Y. P., Nadine, S. E., Traore, I. T., Chantal, Y., Tinto, H. (2025). Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial. Science Journal of Public Health, 13(4), 177-188. https://doi.org/10.11648/j.sjph.20251304.12

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ACS Style

Kiswendsida, Y. P.; Nadine, S. E.; Traore, I. T.; Chantal, Y.; Tinto, H. Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial. Sci. J. Public Health 2025, 13(4), 177-188. doi: 10.11648/j.sjph.20251304.12

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AMA Style

Kiswendsida YP, Nadine SE, Traore IT, Chantal Y, Tinto H. Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial. Sci J Public Health. 2025;13(4):177-188. doi: 10.11648/j.sjph.20251304.12

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@article{10.11648/j.sjph.20251304.12,
  author = {Yanogo Pauline Kiswendsida and Sanou Estelle Nadine and Isidore Tiandiogo Traore and Yanogo Chantal and Halidou Tinto},
  title = {Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial
},
  journal = {Science Journal of Public Health},
  volume = {13},
  number = {4},
  pages = {177-188},
  doi = {10.11648/j.sjph.20251304.12},
  url = {https://doi.org/10.11648/j.sjph.20251304.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20251304.12},
  abstract = {The implementation of seasonal malaria chemoprevention (SMC) in Burkina Faso has not achieved its objective of reducing by at least 60% the morbidity associated with malaria in children under 5 years of age. We assessed a new approach of delivery consisting for the community health workers to directly supervise the three doses of the treatment compared to the standard of delivery (only the first dose directly observed treatment). The objective of the study was to compare the superiority of three doses supervised intake of SMC (3DOT) to the supervised intake of the first dose only. Three centers for health and social promotion were randomly selected in the Gaoua health district (3DOT) and 4 in the Boromo health district (1DOT) to receive a monthly four rounds of SMC with Sulfadoxine-pyrimethamine plus Amodiaquine (SP+AQ) in a quasi-experimental cluster randomized trial, before-after with a control group design which included in total 2440 children. The primary endpoint was the reduction in prevalence between each SMC round. The Khi-2 test was used to assess the superiority of 3DOT versus 1DOT. The reduction of malaria prevalence was significantly higher in 3DOT compared to the 1DOT, 68.60% vs 53.00% (p<.0001). The coverage in the 3DOT was significantly lower than that in the 1DOT, 81.39% versus 95.72%; p<0.0001 for optimal coverage. The 3DOT delivery approach of SMC provides better reduction of malaria prevalence than the 1DOT. However, the lower coverage obtained with the 3DOT compared to the 1DOT is a concerning issue to overcome in the perspective of the scale-up of this strategy at large scale.},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Superiority of Three Directly Observed Treatment Compared to One Directly Observed Treatment in the Seasonal Malaria Chemoprevention in Children Aged Under Five in Burkina Faso: A Quasi-Experimental Trial

AU  - Yanogo Pauline Kiswendsida
AU  - Sanou Estelle Nadine
AU  - Isidore Tiandiogo Traore
AU  - Yanogo Chantal
AU  - Halidou Tinto
Y1  - 2025/07/16
PY  - 2025
N1  - https://doi.org/10.11648/j.sjph.20251304.12
DO  - 10.11648/j.sjph.20251304.12
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 177
EP  - 188
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20251304.12
AB  - The implementation of seasonal malaria chemoprevention (SMC) in Burkina Faso has not achieved its objective of reducing by at least 60% the morbidity associated with malaria in children under 5 years of age. We assessed a new approach of delivery consisting for the community health workers to directly supervise the three doses of the treatment compared to the standard of delivery (only the first dose directly observed treatment). The objective of the study was to compare the superiority of three doses supervised intake of SMC (3DOT) to the supervised intake of the first dose only. Three centers for health and social promotion were randomly selected in the Gaoua health district (3DOT) and 4 in the Boromo health district (1DOT) to receive a monthly four rounds of SMC with Sulfadoxine-pyrimethamine plus Amodiaquine (SP+AQ) in a quasi-experimental cluster randomized trial, before-after with a control group design which included in total 2440 children. The primary endpoint was the reduction in prevalence between each SMC round. The Khi-2 test was used to assess the superiority of 3DOT versus 1DOT. The reduction of malaria prevalence was significantly higher in 3DOT compared to the 1DOT, 68.60% vs 53.00% (p<.0001). The coverage in the 3DOT was significantly lower than that in the 1DOT, 81.39% versus 95.72%; p<0.0001 for optimal coverage. The 3DOT delivery approach of SMC provides better reduction of malaria prevalence than the 1DOT. However, the lower coverage obtained with the 3DOT compared to the 1DOT is a concerning issue to overcome in the perspective of the scale-up of this strategy at large scale.
VL  - 13
IS  - 4
ER  -

Copy | Download