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In 2022, the World Health Organization extended their guidelines for perennial malaria chemoprevention (PMC) from infants to children up to 24 months old. However, evidence for PMC's public health impact is primarily limited to children under 15 months. Further research is needed to assess the public health impact and cost-effectiveness of PMC, and the added benefit of further age-expansion. We integrated an individual-based model of malaria with pharmacological models of drug action to address these questions for PMC and a proposed age-expanded schedule (referred as PMC+, for children 03-36 months).
When models are used to inform decision-making, both their strengths and limitations must be considered. Using malaria as an example, we explain how and why models are limited and offer guidance for ensuring a model is well-suited for its intended purpose.
Malaria is a leading cause of death in school-aged children in sub-Saharan Africa, and non-fatal chronic malaria infections are associated with anaemia, school absence and decreased learning, preventing children from reaching their full potential. Malaria chemoprevention has led to substantial reductions in malaria in younger children in sub-Saharan Africa.