Effectiveness of seasonal malaria chemoprevention administered in a mass campaign in the Kedougou region of Senegal in 2016: a Case-control study

<p><strong><span>Context</span></strong></p> <p><span>Seasonal malaria chemoprevention (SMC) with Sulfadoxine-Pyrimethamine plus Amodiaquine (SPAQ) is a malaria prevention strategy recommended since 2012 by the World Health Organization (WHO) for children under 5 years of age. In Senegal, the scaling up of the SMC has started since 2013 in the south-eastern regions of the country with an extension of the target to 10 years old children. The scaling up of SMC requires a regular evaluation of the strategy as recommended by the WHO. This study was conducted to evaluate the effectiveness of SMC. </span></p> <p><strong><span>Methodology </span></strong></p> <p><span>A case-control study was conducted in some villages of the health districts of Saraya and Kedougou in the Kedougou region from July to December 2016. A "case" was a sick child, aged 3 months to 10 years, seen in consultation and with a positive RDT. The "control" was a child of the same age group with a negative RDT and living in the same compound as the case or in a neighbouring compound. Each case was matched with two controls. Exposure to SMC was assessed by interviewing the mothers/caretakers and by checking the SMC administration card.</span></p> <p><strong><span>Results</span></strong></p> <p><span>A total of 492 children, including 164 cases and 328 controls, were recruited for our study. Their mean ages were 5.32 (+/- 2.15) and 4.44 (+/-2.25) years for the cases and the controls respectively. Male children predominated in both cases (55.49%) and controls (51.22%) (p=</span><span>0.18)</span><span>. Net ownership was 85.80% among cases and 90.85% among controls (p=0.053). The proportion of controls who received SMC was higher than that of cases (98.17% vs 85.98%; (p=1.10^-7)). The protective effectiveness of SMC was 89% </span><span>(IC 95% = 84–93%)</span><span> </span><span>(OR=0.11).</span></p> <p><strong><span>Conclusion </span></strong></p> <p><span>SMC is therefore an effective strategy in the control of malaria in children. Case-control studies are a good approach for monitoring the efficacy of drugs administered during SMC.</span></p>