Seasonal malaria chemoprevention (SMC)

Last update: 7 March 2016

Seasonal malaria chemoprevention is defined as the intermittent administration of full treatment courses of an antimalarial medicine to children during the malaria season in areas of highly seasonal transmission.

The objective is to prevent malarial illness by maintaining therapeutic antimalarial drug concentrations in the blood throughout the period of greatest malarial risk. WHO recommends SMC with sulfadoxine-pyrimethamine + amodiaquine in areas with highly seasonal malaria transmission in the Sahel sub-region of sub-Saharan Africa, where P. falciparum is sensitive to both antimalarial medicines.

Across the Sahel sub-region, most childhood malarial disease and deaths occur during the rainy season, which is generally short (3-4 months). Giving effective antimalarial treatment at monthly intervals during this period has been shown to be 75% protective against uncomplicated and severe malaria in children under 5 years of age. SMC is cost-effective and safe and can be administered by community-health workers. In areas where SMC is implemented, intermittent preventive treatment in infants (IPTi) should not be deployed.

An estimated 25 million children aged 3-59 months could benefit from seasonal malaria chemoprevention every year. WHO issued its SMC recommendation in March 2012. Prior to that, SMC was referred to in the research literature as Intermittent Preventive Treatment in children, or IPTc. In August 2013, WHO released an implementation guide to help countries adopt and implement this new intervention.

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