Seasonal malaria chemoprevention: closing the know–do gap

Abstract

Malaria continues to impact on young lives, causing sickness, impaired school performance, disability, and preventable death, with little progress made to reduce the overall burden since 2014. 1 Ashley EA Poespoprodjo JR Treatment and prevention of malaria in children. Lancet Child Adolesc Health. 2020; 4: 775-789 Summary Full Text Full Text PDF Scopus (6) Google Scholar , 2 WHOWorld malaria report 2020: 20 years of global progress and challenges. World Health Organization, Geneva2020https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2020Date accessed: November 30, 2020 Google Scholar In 2019, 274 000, or 67%, of all malaria deaths were in children younger than 5 years in sub-Saharan Africa. 2 WHOWorld malaria report 2020: 20 years of global progress and challenges. World Health Organization, Geneva2020https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2020Date accessed: November 30, 2020 Google Scholar WHO has recommended seasonal malaria chemoprevention (SMC) for malaria control in areas across the Sahel sub-region since 2012. 3 WHOWHO policy recommendation: seasonal malaria chemoprevention (SMC) for Plasmodium falciparum malaria control in highly seasonal transmission areas of the Sahel sub-region in Africa. World Health Organization, Geneva2012 Google Scholar These areas are characterised by a unimodal rainfall pattern, with the majority (at least 60%) of confirmed malaria cases in children younger than 5 years occurring in a short period of not more than 4 consecutive months. In these areas, sulfadoxine–pyrimethamine plus amodiaquine retains an antimalarial effectiveness of more than 90%. A complete treatment course of sulfadoxine–pyrimethamine plus amodiaquine is given to children aged between 3 and 59 months at monthly intervals, beginning at the start of the transmission season, to a maximum of four doses. 3 WHOWHO policy recommendation: seasonal malaria chemoprevention (SMC) for Plasmodium falciparum malaria control in highly seasonal transmission areas of the Sahel sub-region in Africa. World Health Organization, Geneva2012 Google Scholar Effectiveness of seasonal malaria chemoprevention at scale in west and central Africa: an observational studySMC at scale was effective in preventing morbidity and mortality from malaria. Serious adverse reactions were rarely reported. Coverage varied, with some areas consistently achieving high levels via door-to-door campaigns. Markers of resistance to sulfadoxine–pyrimethamine and amodiaquine remained uncommon, but with some selection for resistance to sulfadoxine–pyrimethamine, and the situation needs to be carefully monitored. These findings should support efforts to ensure high levels of SMC coverage in west and central Africa. Full-Text PDF Open Access