ArticleMalaria journal2023
Seasonal malaria chemoprevention in a context of high presumed sulfadoxine-pyrimethamine resistance: malaria morbidity and molecular drug resistance profiles in South Sudan.
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 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Prevalence of antimalaria drug resistance-conferring mutations associated with sulphadoxine-pyrimethamineine-resistant Plasmodium falciparum in East Africa: a systematic review and meta-analysis.Annals of clinical microbiology and antimicrobials · 2025Pooled it
- Systematic review on the cost of seasonal malaria chemoprevention (SMC).Malaria journal · 2024Pooled it
- Seasonal malaria chemoprevention effectiveness and drug resistance in Plasmodium falciparum: a matched parallel cohort study, Kenya.Bulletin of the World Health Organization · 2026Article
- Implementing seasonal malaria chemoprevention in conflict-affected settings: experiences from Northern Bahr el Ghazal, South Sudan.Malaria journal · 2026Article
- Molecular markers of antimalarial drug resistance in pfk13, pfmdr1, pfdhfr, and pfdhps genes of Plasmodium falciparum in a rural municipality in Cubal, Benguela Province, Angola (2022-2023).Malaria journal · 2026Article
- SevereInfection and drug resistance · 2026Article
- Advances in population-based interventions to control falciparum malaria.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2025Review
- Impact of seasonal malaria chemoprevention: a plausibility evaluation of routine data from health facilities in three implementing states in Nigeria.Malaria journal · 2025Article
- Seasonal malaria chemoprevention in northern Mozambique: a cost-effectiveness analysis.Malaria journal · 2025Article
- A roadmap for understanding sulfadoxine-pyrimethamine in malaria chemoprevention.Parasitology · 2025Review
- Chemoprevention of malaria with long-acting oral and injectable drugs: an updated target product profile.Malaria journal · 2024Review
Corrections and comments
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Authors and funding
16 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeasonal malaria chemoprevention (SMC) using sulfadoxine-pyrimethamine plus amodiaquine (SP-AQ), is a community-based malaria preventive strategy commonly used in the Sahel region of sub-Saharan Africa. However, to date it has not been implemented in East Africa due to high SP resistance levels. This paper is a report on the implementation of SMC outside of the Sahel in an environment with a high level of presumed SP-resistance: five cycles of SMC using SPAQ were administered to children 3-59 months during a period of high malaria transmission (July-December 2019) in 21 villages in South Sudan.
methodsA population-based SMC coverage survey was combined with a longitudinal time series analysis of health facility and community health data measured after each SMC cycle. SMC campaign effectiveness was assessed by Poisson model. SPAQ molecular resistance markers were additionally analysed from dried blood spots from malaria confirmed patients.
resultsIncidence of uncomplicated malaria was reduced from 6.6 per 100 to an average of 3.2 per 100 after SMC administration (mean reduction: 53%) and incidence of severe malaria showed a reduction from 21 per 10,000 before SMC campaign to a mean of 3.3 per 10,000 after each cycle (mean reduction: 84%) in the target group when compared to before the SMC campaign. The most prevalent molecular haplotype associated with SP resistance was the IRNGE haplotype (quintuple mutant, with 51I/59R/108N mutation in pfdhfr + 437G/540E in pfdhps). In contrast, there was a low frequency of AQ resistance markers and haplotypes resistant to both drugs combined (< 2%).
conclusionsThe SMC campaign was effective and could be used as an additional preventive tool in seasonal malaria settings outside of the Sahel, especially in areas where access to health care is unstable. Malaria case load reduction was observed despite the high level of resistance to SP.
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