YSPH EMD Seminar: "Leveraging Causal Inference Methods to Optimize Chemoprevention Strategies for Malaria Control and Elimination"

In sub-Saharan Africa, nearly 1 in 5 people are diagnosed with malaria every year, most of whom are pregnant women and children. Chemoprevention with efficacious antimalarials can be a valuable tool in both control and elimination settings through treating existing and preventing new infections.
In moderate-to-high transmission settings, sulfadoxine-
pyrimethamine (SP) is the most common antimalarial used in chemoprevention regimens for pregnant women and children. However, in the past two decades, SP has been losing its efficacy due to drug resistance. Numerous trials in pregnant women have shown that while SP exhibits weaker efficacy against malaria compared to other more potent antimalarials, SP demonstrates superior efficacy against adverse birth outcomes, suggesting SP’s effects extend beyond its antimalarial activity. In this talk, Dr. Roh will describe the most plausible reason for this phenomenon and how causal inference methods can be applied to: (1) understand the potential mechanisms underlying SP’s ‘non-malarial’ effect and (2) inform optimized regimens for pregnant women and children in Africa.

In countries nearing elimination, chemoprevention through mass drug administration (MDA) that has received renewed interest as a tool to accelerate moderate-to-low transmission settings toward malaria elimination. Dr. Roh will describe her work on a cluster randomized controlled trial in Senegal and future projects using trial data to inform optimally tailored campaigns and the next phase of targeted interventions after MDA.