Malaria Chemoprevention Theme
The WWARN Malaria Chemoprevention Theme aims to synthesis evidence about the optimal development of malaria chemoprevention and other chemoprevention strategies in Africa. This theme will establish a research programme dedicated to malaria chemoprevention in children via systematic review of the published literature, developing a standardised individual-patient data reuse platform, and pooled individual patient data meta-analyses.
These outputs are aimed at improving the deployment of chemoprevention strategies for children living in malaria-endemic parts of Africa.
Approximately 55 million children across 17 countries in sub-Saharan Africa had malaria chemoprevention in 2024, but the effects of broadening malaria chemoprevention recommendations to other endemic regions and to a larger age range are still unclear.
In particular, malaria chemoprevention was originally deployed only in children aged between three months and five years (3-59 months) across the Sahel region of Africa, a belt of intense seasonal malaria transmission. In 2022, WHO broadened substantially their recommendations for malaria chemoprevention to other geographic endemic regions in central, and Eastern and Southern Africa - where drug resistance is much worse, and malaria transmission is less seasonal. In these parts of Africa other antimalarials may be better alternative drugs.
The effects of age, known resistance mutations and transmission intensity/seasonality on chemoprevention efficacy in young children are not well characterised. Of particular interest is the relationship between prevention of clinical malaria and the prevention of severe malaria (hospitalisation due to malaria), where age is a likely effect modifier. Understanding these relationships will help inform current cost-effectiveness modelling.
The WWARN malaria chemoprevention theme aims to address these key questions by:
- Living mapping review of all studies conducted in sub-Saharan Africa since the year 2000
- Curation of individual participant data from available studies (randomized and non-randomised)
- Individual participant data meta-analysis of studies to inform guidelines
The Malaria Chemoprevention Theme falls under the Worldwide Antimalarial Resistance Network (WWARN), and is governed by IDDO data re-use framework. The leadership and strategic direction of WWARN is overseen by a steering committee, co-chaired by IDDO Director Professor Philippe Guerin. The rest of the committee includes a rotating cohort of malaria experts.
The Malaria Chemoprevention Theme is led by Dr Paul Sondo, with Dr James Watson as the theme co-lead. In seeking leadership, preference has been given to researchers from lower- or middle-income country.
The WWARN Programme and Project Managers support all malaria-related projects, ensuring operational continuity and project management efficiency.
