Discussion
malaria
MALARIA
This study component assessed the protective effectiveness of SMC using SPAQ in a region known to have high prevalence of molecular markers of SP resistance. It was part of larger phase 1 SMC implementation research project with several other study components whose results will be presented elsewhere. Historically, the WHO recommended SMC with SPAQ to be implemented in the Sahel, where parasite resistance to SP is known to be low and SPAQ retains its therapeutic efficacy [The study reported here is one of the first to provide evidence of the protective effect of SMC in the context of high parasite resistance. Effectiveness was high with SMC conferring a protective effect of 92%. Most children in the intervention arm (90%) did not develop any clinical malaria episode during the study period, compared to only 14% in the control group. Results from studies conducted in the Sahel region, an area of low SP resistance, demonstrated comparable protective effect sizes [This is not the only study which has demonstrated that chemoprevention with regimes containing SP in areas of high SP resistance provides protection against malaria. One study on IPTp conducted in 2007 showed that even in areas where a high proportion of This study provides novel empirical evidence on the effectiveness of SMC using SPAQ in reducing malaria incidence. It substantiates evidence of the impact of SMC on malaria incidence and protective effect of SMC as demonstrated in similar studies in other African countries [