Individuals, mainly children, who have been hospitalized for severe anemia are at a higher risk of hospital readmission and death due to malaria. No prevention strategies are available to address this issue. This study aims to evaluate the efficacy of malaria chemoprevention after severe anemia in children in endemic-struck areas in Africa.

This two-group, multicenter, placebo-controlled, and randomized clinical trial included a total of 1,049 children younger than 5 years of age who were admitted before for severe anemia. All the eligible participants received standard in-hospital care. The participants were randomly assigned to receive dihydroartemisinin-piperaquine (chemoprevention group) or placebo. The primary outcome of the study was one or more hospital readmissions or death.

Of 1,049 eligible participants, 524 were assigned to the chemoprevention group and 525 to the placebo group. At week 26, 184 events of readmission or death were reported in the chemoprevention group, compared with 316 in the placebo group. However, the lower incidence of readmission in the chemoprevention group was restricted only to the intervention period (week 3-14).

The research concluded that post-discharge malaria chemoprevention after severe sickle cell anemia with monthly dihydroartemisinin-piperaquine was associated with a lower incidence of readmission and death during the intervention period.