Seasonal malaria chemoprevention: successes and missed opportunities

by Matthew E. Coldiron, Lorenz Von Seidlein and Rebecca F. Grais
Malaria Journal, 2017 16:481 – Published: 28 November 2017

4 pp. 847 kB
https://malariajournal.biomedcentral.com/track/pdf/10.1186/s12936-017-2132-1?
site=malariajournal.biomedcentral.com

Seasonal malaria chemoprevention (SMC) was recommended in 2012 for young children in the Sahel during the peak malaria transmission season. Children are given a single dose of sulfadoxine/pyrimethamine combined with a 3-day course of amodiaquine, once a month for up to 4 months. Roll-out and scale-up of SMC has been impressive, with 12 million children receiving the intervention in 2016. There is evidence of its overall benefit in routine implementation settings, and a meta-analysis of clinical trial data showed a 75% decrease in clinical malaria compared to placebo. SMC is not free of shortcomings. Its target zone includes many hard-to-reach areas, both because of poor infrastructure and because of political instability. Treatment adherence to a 3-day course of preventive treatment has not been fully documented, and could prove challenging. As SMC is scaled up, integration into a broader, community-based paradigm which includes other preventive and curative activities may prove beneficial, both for health systems and for recipients.

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