Abomey

The trial investigates delivery strategies to improve how post-discharge malaria chemoprevention (PDMC) is given to children under 10 years old in Benin who were hospitalized with severe anaemia or severe malaria. PDMC aims to reduce hospital readmissions and deaths by providing a monthly 3-day malaria drug regimen three times after hospital discharge. This research addresses the lack of a clear delivery method for PDMC and the challenge of ensuring caregivers follow the dosing schedule. The study follows a cluster randomized design to compare different community delivery approaches and adherence support methods, with the goal of informing national health policies in malaria-endemic areas. Children in the study receive three courses of dihydroartemisinin-piperaquine at 2, 6, and 10 weeks after leaving the hospital. The trial compares three groups: one where caregivers receive all PDMC drugs at discharge plus monthly home visit reminders from community health workers (CHWs); another where CHWs deliver the drugs at home with SMS/phone reminders from qualified officers; and a control group where caregivers get the drugs at discharge without additional reminders. All children receive standard hospital care including blood transfusions and malaria treatment. The study also includes economic and acceptability evaluations of the delivery methods. Participants will be followed for 14 weeks post-discharge with clinic visit monitoring, unannounced home visits to check drug adherence, and an end-of-study visit. Data collected will include hospital readmissions, clinic visits, mortality rates, and adherence to the 9-dose PDMC regimen. Researchers will assess the effectiveness, feasibility, acceptability, and cost-effectiveness of the delivery strategies while monitoring safety events. The entire study spans 36 months, including preparation, recruitment, follow-up, and data analysis phases.