ArticleMalaria journal2023
A non-randomized controlled trial to assess the protective effect of SMC in the context of high parasite resistance in Uganda.
Article in Malaria journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 36 citations in OpenAlex.
- Multiple local PfDHFR I164L haplotype expansions drive Plasmodium falciparum antifolate resistance in Uganda.Nature communications · 2026Article
- Implementing seasonal malaria chemoprevention in conflict-affected settings: experiences from Northern Bahr el Ghazal, South Sudan.Malaria journal · 2026Article
- Extension of seasonal malaria chemoprevention to older children: a pragmatic comparative study in two health districts in the Zinder region, Niger.BMC infectious diseases · 2026Observational
- Trends in Plasmodium falciparum resistance markers to sulfadoxine-pyrimethamine and amodiaquine over ten years of seasonal malaria chemoprevention in Moissala Health District, Chad.Malaria journal · 2025Article
- Global medium-term research priority setting for seasonal malaria chemoprevention: results from an eDelphi study.BMJ global health · 2025Article
- "We witnessed medicines help our children, then we became proud": experiences and acceptability of seasonal malaria chemoprevention in Aweil, South Sudan.Malaria journal · 2025Article
- Seasonal malaria chemoprevention in northern Mozambique: a cost-effectiveness analysis.Malaria journal · 2025Article
- Impact of dhps mutations on sulfadoxine-pyrimethamine protective efficacy and implications for malaria chemoprevention.Nature communications · 2025Article
- Phase one of a hybrid effectiveness-implementation study to assess the feasibility, acceptability and effectiveness of implementing seasonal malaria chemoprevention in Nampula Province, Mozambique.Malaria journal · 2025Article
- A roadmap for understanding sulfadoxine-pyrimethamine in malaria chemoprevention.Parasitology · 2025Review
- Optimization of in vivo antimalarial efficacy of combinations of aqueous leaf extracts of Artemisia annua L., Vernonia amygdalina Del, and Microglossa pyrifolia (Lam.) Kuntze using factorial design.BMC complementary medicine and therapies · 2024Article
- Examination of factors impacting spitting or vomiting among children under 5 years of age during seasonal malaria chemoprevention: a quantitative study in Burkina Faso, Chad, Nigeria and Togo.Tropical medicine and health · 2024Article
- Chemoprevention of malaria with long-acting oral and injectable drugs: an updated target product profile.Malaria journal · 2024Review
- Barriers to the quality delivery of seasonal malaria chemoprevention in Chad and Burkina Faso: a qualitative exploration of caregivers and community distributors' perspectives.Malaria journal · 2024Article
- Article
- Design and selection of drug properties to increase the public health impact of next-generation seasonal malaria chemoprevention: a modelling study.The Lancet. Global health · 2024Article
- Malaria trends in districts that were targeted and not-targeted for seasonal malaria chemoprevention in children under 5 years of age in Guinea, 2014-2021.BMJ global health · 2024Article
- A quasi-experimental study to estimate effectiveness of seasonal malaria chemoprevention in Aweil South County in Northern Bahr El Ghazal, South Sudan.Malaria journal · 2024Article
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Authors and funding
21 authors at 4 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUntil recently, due to widespread prevalence of molecular markers associated with sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ) resistance in east and southern Africa, seasonal malaria chemoprevention (SMC) has not been used at scale in this region. This study assessed the protective effectiveness of monthly administration of SP + AQ (SPAQ) to children aged 3-59 months in Karamoja sub-region, Uganda, where parasite resistance is assumed to be high and malaria transmission is seasonal.
methodsA two-arm quasi-experimental, open-label prospective non-randomized control trial (nRCT) was conducted in three districts. In two intervention districts, 85,000 children aged 3-59 months were targeted to receive monthly courses of SMC using SPAQ during the peak transmission season (May to September) 2021. A third district served as a control, where SMC was not implemented. Communities with comparable malaria attack rates were selected from the three districts, and households with at least one SMC-eligible child were purposively selected. A total cohort of 600 children (200 children per district) were selected and followed using passive surveillance for breakthrough confirmed malaria episodes during the five-month peak transmission season. Malaria incidence rate per person-months and number of malaria episodes among children in the two arms were compared. Kaplan-Meier failure estimates were used to compare the probability of a positive malaria test. Other factors that may influence malaria transmission and infection among children in the two arms were also assessed using multivariable cox proportional hazards regression model.
resultsThe malaria incidence rate was 3.0 and 38.8 per 100 person-months in the intervention and control groups, respectively. In the intervention areas 90.0% (361/400) of children did not experience any malaria episodes during the study period, compared to 15% (29/200) in the control area. The incidence rate ratio was 0.078 (95% CI 0.063-0.096), which corresponds to a protective effectiveness of 92% (95% CI 90.0-94.0) among children in the intervention area.
conclusionSMC using SPAQ provided high protective effect against malaria during the peak transmission season in children aged 3-59 months in the Karamoja sub-region of Uganda.
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