Rapid assessments for the deployment of seasonal malaria chemoprevention in new geographies of east and southern Africa: protocol for a hybrid type II implementation study

Seasonal malaria chemoprevention (SMC) is a highly effective community-based intervention to prevent malaria infections caused by Plasmodium falciparum in areas where the burden of malaria is high and malaria transmission is seasonal. SMC is commonly seen as a success story in the Sahel region, however, there are regions in east and southern Africa where malaria transmission is seasonal, and the burden is high. However, the same blanket approach that was used in the Sahel cannot be applied in east and southern Africa due to higher pre-existing resistance to the drugs used, seasonality heterogeneity, contextual difference, and unknown cost-effectiveness, amongst others. Rapid Assessments in the Niassa region of Mozambique, in the southeast region of Malawi and in the Lubumbashi region of the DRC are expected to begin in March, April and November 2023, respectively. In 2024 the rapid assessments are planned to be conducted in in Madagascar, Angola, and Tanzania. These will be the first studies analysing the effectiveness, chemoprevention efficacy, feasibility, acceptability, and potential scale-up impact of SMC in new east and southern Africa geographies. The outcomes of these studies should impact future policy changes at national and international levels and potentially allow for a historically successful program to expand in a sustained and cost-effective way beyond the Sahel region.

The protocol is divided into five different components with different objectives that feed into each other: (1) a cluster randomized controlled trial to estimate the effectiveness of SMC with SP+AQ in several new geographies ; (2) a non-randomized two arm trial to estimate the chemoprevention efficacy of SP+AQ; (3) a molecular analysis of the prevalence of resistance markers to SP and AQ, (4) a dynamical modelling exercise to estimate the impact of SMC and where to prioritise future scale-up; and (5) a qualitative study that will evaluate the feasibility and acceptability of the intervention.

Malaria Consortium resource

Drug-based Strategies

Mar 2023 — Dec 2024

Angola
Dem. Rep. of Congo
Madagascar
Malawi
Mozambique
Tanzania
Zambia
Zimbabwe

Seasonal Malaria Chemoprevention (SMC)
Tracking progress against the PMI Insights Research Priorities