Expanding seasonal malaria chemoprevention beyond the Sahel region

Seasonal malaria chemoprevention (SMC) has emerged as a primary intervention in malaria control, protecting more than 49 million children in 2022, primarily in West Africa's Sahel region. WHO now recommends SMC in all areas where more than 60% of malaria cases occur within four consecutive months, and clinical attack rate (without SMC) is at least 0·1 episodes per child during the transmission season. However, implementation in East and Southern Africa has been limited, partly due to concerns about high-grade resistance to sulfadoxine–pyrimethamine, a key component of the standard SMC drug combination with amodiaquine (SPAQ).

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