Community Delivery Strategies for Post-Discharge Malaria Prevention in Children Under 10 in Benin Cluster Randomized Trial to Improve Medication Adherence and Reduce Hospital Readmissions

What this Trial Is About

Researchers are conducting implementation trials in Benin to evaluate different ways of delivering post-discharge malaria chemoprevention PDMC to children under 10 years old who were hospitalized with severe anaemia or severe malaria. The study aims to find effective delivery methods and adherence support to reduce hospital readmissions and deaths after discharge. This trial is a phase 4 cluster randomized study designed to provide evidence to support national health policies and scaling up PDMC in malaria-endemic areas. Participants will receive three courses of a 3-day PDMC treatment with dihydroartemisinin-piperaquine at weeks 2, 6, and 10 after hospital discharge. The study compares two community delivery strategies one where caregivers receive all PDMC drugs at discharge with monthly home visit reminders, and another where community health workers deliver the drugs at home with SMS or phone reminders. A control group will receive the drugs at discharge without additional adherence support. All children also receive standard hospital care for severe anaemia or malaria during admission. Throughout the 14 weeks following discharge, children will be monitored for adherence to PDMC and health outcomes including hospital readmissions, clinic visits, and mortality. Researchers will collect data through household visits, passive surveillance, and unannounced home visits to check medication adherence. The study also includes economic, acceptability, and feasibility evaluations to assess cost-effectiveness, stakeholder views, and practical aspects of implementing PDMC delivery methods. The total study duration spans 36 months, including preparation, recruitment, follow-up, and data analysis.

Post-discharge Malaria Chemoprevention Implementation Trial in Benin