Correction: Safety of Seasonal Malaria Chemoprevention (SMC) with Sulfadoxine-Pyrimethamine plus Amodiaquine when Delivered to Children under 10 Years of Age by District Health Services in Senegal: Results from a Stepped-Wedge Cluster Randomized Trial

[This corrects the article DOI: 10.1371/journal.pone.0162563.].

Safety of Seasonal Malaria Chemoprevention (SMC) with Sulfadoxine-Pyrimethamine plus Amodiaquine when Delivered to Children under 10 Years of Age by District Health Services in Senegal: Results from a Stepped-Wedge Cluster Randomized Trial

Background

It is recommended that children aged 3 months to five years of age living in areas of seasonal transmission in the sub-Sahel should receive Seasonal Malaria Chemoprevention (SMC) with sulfadoxine-pyrimethamine plus amodiaquine (SPAQ) during the malaria transmission season. The purpose of this study was to evaluate the safety of SMC with SPAQ in children when delivered by community health workers in three districts in Senegal where SMC was introduced over three years, in children from 3 months of age to five years of age in the first year, then in children up to 10 years of age.

Methods

A surveillance system was established to record all deaths and all malaria cases diagnosed at health facilities and a pharmacovigilance system was established to detect adverse drug reactions. Health posts were randomized to introduce SMC in a stepped wedge design. SMC with SPAQ was administered once per month from September to November, by nine health-posts in 2008, by 27 in 2009 and by 45 in 2010.

Results

After three years, 780,000 documented courses of SMC had been administered. High coverage was achieved. No serious adverse events attributable to the intervention were detected, despite a high level of surveillance.

Conclusions

SMC is being implemented in countries of the sub-Sahel for children under 5 years of age, but in some areas the age distribution of cases of malaria may justify extending this age limit, as has been done in Senegal. Our results show that SMC is well tolerated in children under five and in older children. However, pharmacovigilance should be maintained where SMC is implemented and provision for strengthening national pharmacovigilance systems should be included in plans for SMC implementation.

Trial Registration

ClinicalTrials.gov NCT 00712374

[Prevalence of diabetic retinopathy at the Dakar University Hospital Center]

The aim of the study is to appreciate the prevalence of diabetic retinopathy among senegalese patients in analyzing age of diagnosis, duration of diabetes, plasma glucose and type of retinopathy. 129 diabetics followed and treated in the diabetic center of internal medicine clinic (Dakar University) were examined by 90 degrees Volk's lens. A determination of plasma c peptide and glucose concentration were performed. 55 (mean age 224. +/- 0.9 years) were insulino-dependent and 74 (mean age of 54.7 +/- 11.4 years) non insulinodependent. On average the duration of diabetes was 5.4 years +/- 5.4 for the former and 6.07 +/- 5.7 for the latter with respectively glucose plasma average 2.60 g/l +/- 0.7 and 1.7 g/l +/- 0.83. Retinopathy was found in 29 patients. So total prevalence was 22.48%, shared in 29.7% for non insulino-dependant and 12.7% for insulino-dependent. In 7 cases the retinopathy was proliferative and non proliferative in 22 cases essentially among non insulino-dependant diabetics. The diabetic retinopathy is one of handicaping complications of diabetics. Its prevalence is strongly linked to the duration of diabetes, glycaemic control and to other risk factors (genetics, glycosylated hemoglobin and high blood pressure).