Management of malaria in children under 5-years-old during COVID-19 pandemic in Sierra Leone: a lesson learned?

Growing evidences are showing the potential indirect effects of COVID-19 on the health systems of low-resource settings, where diseases such as Tuberculosis, HIV and Malaria represent major killers. Therefore, we performed a retrospective study aimed to evaluate the impact of COVID-19 on Malaria programs in a peripheral region of Sierra Leone, previously involved by the Ebola outbreak in 2015, when malaria care have been impaired since local health systems were overwhelmed by Ebola cases. During COVID-19 in Sierra Leone, we did not notice a drop in malaria diagnosis in children, suggesting that a proactive approach in the management of malaria in endemic countries during COVID-19 may have had a positive impact. A comprehensive approach that include also educational activities to sensitize the local population, was useful to guarantee successful malaria diagnosis and treatment, and prevents excess of malaria deaths due to potential disruption of the local health systems related to the SARS-CoV-2 pandemic. Contribution to the field we performed a retrospective study aimed to evaluate the impact of COVID-19 on Malaria programs in a peripheral region of Sierra Leone, previously involved by the Ebola outbreak in 2015, when malaria care have been impaired since local health systems were overwhelmed by Ebola cases. During COVID-19 in Sierra Leone, we did not notice a significant change in the middle term period in malaria diagnosis in children, suggesting that a proactive approach in the management of malaria in endemic countries during COVID-19 may have had a positive impact. A comprehensive approach that include also educational activities to sensitize the local population, was useful to guarantee successful malaria diagnosis and treatment, and prevents excess of malaria deaths due to potential disruption of the local health systems related to the SARS-CoV-2 pandemic. Funding statement nothing to declare Ethics statements Studies involving animal subjects Generated Statement: No animal studies are presented in this manuscript. Studies involving human subjects Generated Statement: The studies involving human participants were reviewed and approved by Bureh Town Community Hospital. Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin. Inclusion of identifiable human data Generated Statement: No potentially identifiable human images or data is presented in this study. Data availability statement Generated Statement: The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.