Preventing malaria during high transmission period: Ghana adopts Seasonal Malaria Chemoprevention

The National Malaria Control Programme is set to roll out a programme under which full treatment courses of antimalarial medicines will be intermittently administered to children during the high malarial transmission period to prevent malarial illness.

The objective of the intervention, which has been titled ‘Seasonal Malaria Chemoprevention’ (SMC), is to maintain therapeutic antimalarial drug concentrations in the blood throughout the period of greatest malarial risk.

The SMC involves administration of four full doses of Sulphurdoxine Pyrimethamine and Amodiaquine (SP-AQ) at monthly intervals to children three to 59 months in areas of highly seasonal malaria transmission.

 

According to the Chief Director of the Ministry of Health, Salimata Abdul-Salam, Ghana had adopted the SMC strategy as a policy and implementation would begin this year in the Upper West Region.

“It is an intervention targeted towards the sahel regions of Ghana which also bear the highest burden of malaria with parasite prevalence ranging from 44 per cent to 51 per cent in children under five years  (MICS 2011).

The strategy, she said, would be implemented in phases in the three regions in the north of Ghana over a period of at most three years, subject to availability of funding. 

 

According to the National Malaria Control programme (NMCP), across the Sahel sub-region, most childhood mortality and morbidity from malaria occurred during the rainy season.

Giving effective antimalarial medicines at full treatment doses at appropriate intervals during this period has shown to prevent illness and death from malaria in children.

The Communication Specialist of the NMCP, Mr Kwame Gakpey, said the World Health Organisation (WHO) recommended that for maximum protection, and to minimise selection of drug resistance,  the complete three-day treatment course each month must be complied with.

He said the combination of SP+AQ was chosen for SMC because in clinical trials, SP+AQ conferred greater protection than other drug combinations.

The two drugs, he expanded, also retained their efficacy in the Sahel and sub-Sahel areas where there were seasonal transmissions.

Mr Gakpey emphasised that the regimen was also safe, well tolerated and relatively cheap.

 

He said in areas where SMC would be implemented, drug resistance would be monitored and a system set up to evaluate and assess the number of breakthrough infections and their intervals from the last dose of SMC.

“All  AQ+SP doses administered will also be recorded while the Health Management Information System (HMIS)  will be strengthened to track all severe malaria, malaria deaths and all confirmed cases of malaria,” said Mr Gakpey.

He said the NMCP had undertaken the necessary advocacy and community mobilisation activities, including training of health personnel, to ensure successful implementation of the intervention.