Factors contributing to preventing malaria in children aged 3 to 59 months after the first cycle of seasonal malaria chemoprevention in Tenkodogo Health District of Burkina Faso, July 2020: A prospective cohort study

Background: The incidence of malaria in children under 5 years in Burkina Faso was 163 per 1000 with a case fatality of 1.5% in 2018. Despite the implementation of several strategies, malaria incidence increased in Tenkodogo Health District after the seasonal malaria chemo prevention (SMC) in 2018. We conducted a study to identify the factors contributing to malaria prevention in children after the first cycle of the seasonal malaria chemoprevention of 2020 in Tenkodogo Health District. Methods: We conducted a prospective cohort study, from June 5 to September 5, 2020 in Tenkodogo Health District, among children aged 03 to 59 months. We employed cluster sampling and selected 847 eligible children. Sociodemographic characteristics of children and their mothers/caregivers, SMC adherence and malaria incidence in the 28 days SMC were collected. The presence of long-lasting insecticide-treated mosquito net (LLNs) in the household was noted when the mother or the babysitter reported having one. Data collectors were able to confirm cohabitation with animals either from their presence in the household or from the residues of their feces. A questionnaire was used, and implemented documents review for data collection. We used Epi info 7 for calculating averages and proportions and carried out multivariate logistic regression. Results: The overall level of SMC adherence was 90.02%. During the 4-week follow-up, malaria incidence was 99.76 cases per 1000 children, increasing from 15.43 to 34.44 cases per 1000 children from the first to the fourth week after the first cycle of SMC. Advice from community health workers was a protective factor against malaria in children (aRR= 0.41; 95% CI [0.22; 0.77]). Conclusion: There was a gradual increase in malaria incidence after the first SMC cycle. Recieving advice from community health workers was a protective factor against malaria after the first cycle of SMC. Measures to strengthen the advice by community health workers are needed to reduce this incidence of malaria in children after first cycle of SMC in Tenkodogo Health District.