Uganda and Mozambique will this year study the use of seasonal malaria chemoprevention (SMC) as a tool against malaria control in areas of highly seasonal transmission.
The World Health Organsation (WHO) defines seasonal malaria chemoprevention or SMC as the intermittent administration of full treatment courses of an antimalarial medicine to children in areas of highly seasonal transmission during the malaria season.
The world health body recommends SMC with Sulfadoxine-Pyrimethamine and Amodiaquine (SPAQ) for children aged 3 to 59 months given in monthly cycles during the season of highest peak (risk) of malaria transmission. WHO estimates SMC can prevent around 75 percent of malaria cases in children under five years. SMC is also a safe and a cost-effective strategy that can be easily administered by health workers and caregivers at the community level.
In Uganda, Karamoja has been identified as a region that qualifies for SMC because it has only one rainy season from May to October and it’s during this time that the region records the highest malaria cases.
Thus Malaria Consortium in collaboration with National Malaria Control Division, in the Ministry of Health, Uganda has planned to conduct a research titled “Evaluating the feasibility, acceptability and protective efficacy of seasonal malaria chemoprevention in two districts in Karamoja, Uganda.”
“We shall pilot SMC with SPAQ to about 70,000 children aged 3-59 months in two districts of Moroto and Kotido in the Karamoja region and study if the intervention is effective, acceptable, and provides protection in a given period. If it works then we roll it out in other districts in Karamoja,” said Dr. Anthony Nuwa, a Senior Country Technical Coordinator, Malaria Consortium Uganda and one of the two Principal investigators. The other is Dr. Jimmy Opigo the assistant commissioner for in charge of the malaria control program at the Ministry of health.
The study will also evaluate costs of delivery, impact on malaria incidence and mortality of SMC, during its administration for five months of the year in Uganda. It will be implemented in collaboration with district leaders.
SMC has already been proven as a highly impactful tool in the fight against malaria in the eligible geographies. SMC a life-saving intervention has proven successful in the Sahel where plasmodium falciparum is sensitive to both antimalarial medicines. As such, SMC has been well accepted and widely deployed by national malaria control programs (NMCPs), government decision-makers and local communities.
The study design consists of implementation and an evaluation component, both embedded in the effectiveness-implementation hybrid (EIH) type one, said Dr. Nuwa.
Researchers say the Karamoja region were the pilot study will be implemented with activities starting this January is an ideal location as malaria interventions rolled out here are not very effective because of the their uniqueness, cultural background, poor housing and nomadic nature of the population.
This study in Uganda will be different as elsewhere where SMC is implemented in the Sahel region and western Africa it is under a four months cycle because the rains occurs between that period while in Uganda it will be under a five months cycle.
“This is another new innovation because our cycle will be different,” said Dr. Nuwa. Malaria elimination remains a huge challenge in Uganda. Identifying different innovations can assist in the Uganda elimination process.
Professor Maha Taysir Barakat, RBM Partnership Board Chair says with ongoing commitment, optimized use of current resources and new investments, countries can deliver on the promise of a malaria-free world.
Malaria is still a leading cause of death in Uganda. According to the WHO World malaria report, in 2019 Uganda accounted for 3% of global malaria deaths, or about 12,000 lives. Since 2000, due to committed global partnership, the world has made tremendous progress against malaria, saving 7.6 million lives and preventing 1.5 billion new infections