Seasonal Malaria Chemoprevention (SMC)

Malaria remains a major public health problem with an estimated burden of 216 million clinical episodes and 655,000 deaths worldwide attributable to malaria in 2010 (Who, 2010 WMR)

A significant proportion (91%) of reported deaths from malaria occurs in sub-Saharan Africa where children under 5 years of age bear the most burden. In 2010, t is estimated that 86% of all malaria deaths occurred in this age group.

In Ghana malaria continues to be the leading cause of outpatient attendance, even though significant gains have been achieved as a result of recent scale up of preventive and curative interventions. In 2014, it accounted for 30% OPD attendance, 27.9% inpatients and 7.2% of all cause deaths. (GHS/DHIMS 2014)

Across the Sahel sub-region, most childhood mortality and morbidity from malaria occurs during

the rainy season, which is generally short. Giving effective antimalarial medicines at full treatment

doses at appropriate intervals during this period has been shown to prevent illness and death from

malaria in children.

In Ghana, the northern part is similar to the conditions prevailing in the sahel region with malaria transmission being relatively seasonal. The malaria burden also appears to be higher in that part of the country than the other areas as detected in surveys on malaria parasite prevalence.

A Multiple Indicator Cluster Survey, MICS, conducted in 2011 showed a wide variation between parasite prevalence in the south (4% in GAR) and the north (51% in UWR).

This observation influenced the decision to implement Seasonal Malaria Chemoprevention as an additional intervention in the Upper West region and subsequently scale up to the entire northern part.

SMC is defined as “the intermittent administration of full treatment courses of an antimalarial medicine during the malaria season to prevent malarial illness with the objective of maintaining therapeutic antimalarial drug concentrations in the blood throughout the period of greatest malarial risk.

The drug of choice for SMC is sulphadoxine-pyrimethamine plus amodiaquine (SP+AQ) which are administered concurrently. The SP is administered on day 1 with 1 tablet of the amodiaquine, followed on the 2 successive days with a daily dose of amodiaquine.

In Ghana the implementation was initially planned to take off in June 214 but due to some logistical challenges, it could not come on but postponed. If plans go on as scheduled, the first dose under SMC will be administered in July for the 2015 cycle of SMC.

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