Evaluation of seasonal malaria chemoprevention implementation in the Upper East region of Northern Ghana

Abstract Background Ghana adopted the WHO-recommended Seasonal Malaria Chemoprevention (SMC) in 2016 following a pilot study as a vital strategy for malaria control. SMC is the intermittent administration of a preventive and curative dose of anti-malarial medicine (Sulfadoxine-Pyrimetamine + Amodiaq...

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Main Authors: Emmanuel Yidana Ayamba, Emmanuel Kofi Dzotsi, William Dormechele, Nana Akosua Ansah, Oscar Bangre, Josephat Ana-Imwine Nyuzaghl, Sydney Ageyomah Abilba, Samuel Kwabena Boakye-Boateng, Patrick Odum Ansah
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Malaria Journal
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Online Access:https://doi.org/10.1186/s12936-025-05322-9
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author Emmanuel Yidana Ayamba
Emmanuel Kofi Dzotsi
William Dormechele
Nana Akosua Ansah
Oscar Bangre
Josephat Ana-Imwine Nyuzaghl
Sydney Ageyomah Abilba
Samuel Kwabena Boakye-Boateng
Patrick Odum Ansah
author_facet Emmanuel Yidana Ayamba
Emmanuel Kofi Dzotsi
William Dormechele
Nana Akosua Ansah
Oscar Bangre
Josephat Ana-Imwine Nyuzaghl
Sydney Ageyomah Abilba
Samuel Kwabena Boakye-Boateng
Patrick Odum Ansah
author_sort Emmanuel Yidana Ayamba
collection DOAJ
description Abstract Background Ghana adopted the WHO-recommended Seasonal Malaria Chemoprevention (SMC) in 2016 following a pilot study as a vital strategy for malaria control. SMC is the intermittent administration of a preventive and curative dose of anti-malarial medicine (Sulfadoxine-Pyrimetamine + Amodiaquine) during four months of the malaria season. This study monitored the implementation of SMC to ensure the intervention is achieving its target. Methods This was a longitudinal study in four administrative districts of the Upper East Region of Ghana. Children aged between 3 and 59 months were sampled and followed up one week after each cycle of SMC dosing to complete a questionnaire. SMC status was determined through the caregiver’s report and child welfare cards, if available. Caregivers were asked if the participant had been treated for malaria since the last cycle. Simple and multiple logistic regressions were employed to determine associations between SMC adherence and the independent variables, with all results interpreted at a 95% confidence level (CI). Results This study reported an average SMC coverage of 87% (CI: 86.7–89.5) per cycle with a 2% dropout after the first cycle. SMC adherence rate remained above 82% (CI: 1.4–2.5), with malaria incidence decreasing in those who received all four doses of SMC compared to partial recipients. Health system/programme (49%) and patient related factors (33%) were the main reasons reported for non-adherence. Significant predictors of adherence were household size (aOR = 1.04, 95% CI 1.01–1.08), sleeping under bed nets (aOR = 1.88, 95% CI 1.44–2.48), and indoor residual spraying (IRS) presence (aOR = 0.83, 95% CI 0.69–1.99). Conclusion Despite achieving an average coverage of 87% per cycle, it falls short of the national target of 90%. Notable reasons for drop-outs and non-adherence were, the caregiver being unavailable during the distribution, highlighting the need for diversified approaches in SMC campaigns to enhance coverage, and adherence, and maximize intervention benefits.
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spelling doaj-art-2799a478a3284786a54b4a07bb13cf5e2025-08-20T02:24:26ZengBMCMalaria Journal1475-28752025-04-0124111010.1186/s12936-025-05322-9Evaluation of seasonal malaria chemoprevention implementation in the Upper East region of Northern GhanaEmmanuel Yidana Ayamba0Emmanuel Kofi Dzotsi1William Dormechele2Nana Akosua Ansah3Oscar Bangre4Josephat Ana-Imwine Nyuzaghl5Sydney Ageyomah Abilba6Samuel Kwabena Boakye-Boateng7Patrick Odum Ansah8Department of Clinical Science, Navrongo Health Research CentreRegional Health DirectorateDepartment of Clinical Science, Navrongo Health Research CentreDepartment of Clinical Science, Navrongo Health Research CentreDepartment of Clinical Science, Navrongo Health Research CentreRegional Health DirectorateRegional Health DirectorateRegional Health DirectorateDepartment of Clinical Science, Navrongo Health Research CentreAbstract Background Ghana adopted the WHO-recommended Seasonal Malaria Chemoprevention (SMC) in 2016 following a pilot study as a vital strategy for malaria control. SMC is the intermittent administration of a preventive and curative dose of anti-malarial medicine (Sulfadoxine-Pyrimetamine + Amodiaquine) during four months of the malaria season. This study monitored the implementation of SMC to ensure the intervention is achieving its target. Methods This was a longitudinal study in four administrative districts of the Upper East Region of Ghana. Children aged between 3 and 59 months were sampled and followed up one week after each cycle of SMC dosing to complete a questionnaire. SMC status was determined through the caregiver’s report and child welfare cards, if available. Caregivers were asked if the participant had been treated for malaria since the last cycle. Simple and multiple logistic regressions were employed to determine associations between SMC adherence and the independent variables, with all results interpreted at a 95% confidence level (CI). Results This study reported an average SMC coverage of 87% (CI: 86.7–89.5) per cycle with a 2% dropout after the first cycle. SMC adherence rate remained above 82% (CI: 1.4–2.5), with malaria incidence decreasing in those who received all four doses of SMC compared to partial recipients. Health system/programme (49%) and patient related factors (33%) were the main reasons reported for non-adherence. Significant predictors of adherence were household size (aOR = 1.04, 95% CI 1.01–1.08), sleeping under bed nets (aOR = 1.88, 95% CI 1.44–2.48), and indoor residual spraying (IRS) presence (aOR = 0.83, 95% CI 0.69–1.99). Conclusion Despite achieving an average coverage of 87% per cycle, it falls short of the national target of 90%. Notable reasons for drop-outs and non-adherence were, the caregiver being unavailable during the distribution, highlighting the need for diversified approaches in SMC campaigns to enhance coverage, and adherence, and maximize intervention benefits.https://doi.org/10.1186/s12936-025-05322-9MalariaSeasonal Malaria Chemoprevention (SMC)CoverageAdherenceNon-adherenceAdverse events
spellingShingle Emmanuel Yidana Ayamba
Emmanuel Kofi Dzotsi
William Dormechele
Nana Akosua Ansah
Oscar Bangre
Josephat Ana-Imwine Nyuzaghl
Sydney Ageyomah Abilba
Samuel Kwabena Boakye-Boateng
Patrick Odum Ansah
Evaluation of seasonal malaria chemoprevention implementation in the Upper East region of Northern Ghana
Malaria Journal
Malaria
Seasonal Malaria Chemoprevention (SMC)
Coverage
Adherence
Non-adherence
Adverse events
title Evaluation of seasonal malaria chemoprevention implementation in the Upper East region of Northern Ghana
title_full Evaluation of seasonal malaria chemoprevention implementation in the Upper East region of Northern Ghana
title_fullStr Evaluation of seasonal malaria chemoprevention implementation in the Upper East region of Northern Ghana
title_full_unstemmed Evaluation of seasonal malaria chemoprevention implementation in the Upper East region of Northern Ghana
title_short Evaluation of seasonal malaria chemoprevention implementation in the Upper East region of Northern Ghana
title_sort evaluation of seasonal malaria chemoprevention implementation in the upper east region of northern ghana
topic Malaria
Seasonal Malaria Chemoprevention (SMC)
Coverage
Adherence
Non-adherence
Adverse events
url https://doi.org/10.1186/s12936-025-05322-9
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