Modelling coverage of Seasonal Malaria Chemoprevention (SMC)

Seasonal Malaria Chemoprevention (SMC) is the monthly administration of antimalarials sulfadoxine-pyrimethamine and amodiaquine (SP + AQ) to children at risk during a country’s peak malaria season. SMC was first recommended for use by the World Health Organization (WHO) in 2012, with 170,000 children treated in that year, and has rapidly expanded culminating in over 40 million children treated in 2021. The intervention was originally recommended for countries in the Sahel sub-region of Africa but has been expanded with Uganda and Mozambique conducting SMC in 2022.

The rapid expansion of SMC is likely to have a significant impact on the global burden of malaria that has yet to be fully explored. The first step in determining impact is to establish a consistent way to define and evaluate SMC intervention coverage. Current Africa-wide SMC coverage maps simply describe the presence or absence of an SMC campaign. However, country reports are available that include detailed information on the number of children treated, how many cycles were conducted and the subnational units targeted. In this project, we are collating all current data on SMC coverage and developing methods that bring together the different coverage indicators used. 

As SMC is a relatively new intervention, these initial coverage estimates will have several uses.  The work has already highlighted the difficulty in defining and standardising coverage which may be used to inform data collection and dissemination decisions for future campaigns. SMC coverage estimates may also be used to highlight areas where coverage can be improved and lead to Africa-wide impact estimates.