Seasonal Malaria Chemoprevention

Mothers and children wait for antimalarial medicine as part of a PMI-supported SMC program in Mali. Photo credit: Erin Eckert
Seasonal Malaria Chemoprevention - Map of Regions, 2018.

Seasonal Malaria Chemoprevention (SMC) is the administration of treatment doses of longer-acting antimalarial medications at monthly intervals in areas of exclusively seasonal transmission. The goal is to treat any existing infections and maintain protective drug concentrations in the blood throughout a complete transmission season. SMC has been shown to be an effective strategy in reducing malaria morbidity and feasible to implement on existing platforms.

Many successful SMC programs are built on an existing community health worker (CHW) or integrated community case management (iCCM) program because CHWs are often best placed to identify children who qualify for SMC, distribute medications, and follow-up to ensure adherence. To ensure effective implementation of a SMC program, PMI suggests that planning for procurement of commodities should be done at least a year in advance given long lead times for delivery.

PMI currently supports SMC activities in BeninBurkina Faso, CameroonGhanaGuineaMali,  Niger, northern Nigeria, and Senegal. SMC activities supported by PMI are in line with the WHO guidelines which include:

  • A treatment dose of amodiaquine plus sulfadoxine-pyrimethamine (AQ+SP)
  • Given to children between 3 and 59 months of age
  • At monthly intervals during the malaria transmission season (maximum four months)

According to WHO recommendations, SMC should not be used in areas that:

  • Also implement intermittent preventive treatment in infants (IPTi)
  • Have demonstrated high-levels of resistance to either SP or AQ

Additionally, SMC is only recommended for geographic regions where the duration of the malaria transmission season is four months or less. SMC is not recommended for the seasonal transmission belt in southern Africa because SP resistance has been documented in that area.


Photo source: Maggie Hallahan Photography