Author contributions
AN was lead writer and editing the paper based on information provided by co-authors and literature reviews. All authors contributed to manuscript development and proof-reading. KB conceived the study with input from CB, MO and CR, AN developed the procedures and wrote the protocol with input from CB, MO and CR AN, MO, TK and MN coordinated the fieldwork with input from DSO, coordinated the laboratory work. All authors reviewed the final manuscript draft and approved its publication. These findings are very promising and support more robust impact studies to support policy change. However, antifolate resistance remains a viable concern; hence, future studies should consider evaluating alternative SMC regimens in terms of effectiveness, feasibility, acceptability and cost effectiveness. All authors read and approved the final manuscript.