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London School of Hygiene & Tropical Medicine Malaria Centre

Malaria research in epidemiology

Seasonal malaria chemoprevention in children: where could it be implemented and what would be its impact?

LSHTM investigators:
Matt Cairns, Anne Wilson, Diadier Diallo, Paul Milligan & Brian Greenwood.
External collaborators:
Arantxa Roca-Feltrer (Malawi- Liverpool-Wellcome Trust Clinical Research Programme, Malawi); Tini Garske & Azra Ghani (Imperial College London, UK).
Funding body:
The Bill & Melinda Gates Foundation & Medical Research Council, UK.

Seasonal malaria chemoprevention (SMC, previously known as intermittent preventive treatment in children, IPTc), is highly effective in areas with a short malaria transmission season.

To assist policy decisions made by WHO on the areas where this intervention would be appropriate, we have reviewed malaria incidence data and defined a surrogate predictor of seasonality in incidence based on rainfall.  Spatial rainfall, malaria endemicity and population data were then used to estimate the population and malaria burden in areas with highly seasonal malaria.  We estimate that in areas suitable for SMC, there are 39 million children under five years of age, 33.7 million child malaria episodes and 152,000 childhood deaths from malaria each year.  The majority of this burden occurs in the Sahelian or sub-Sahelian regions of Africa, where regimens currently available for SMC have been shown to be highly effective, safe and acceptable to communities.  SMC has the potential to avert several million malaria cases and tens of thousands of childhood deaths each year if successfully delivered to the populations at risk.