Evaluation of the Extension of Seasonal Malaria Chemoprevention to 5 Cycles and to Children Aged 6 to 9 Years in Niger: An Observational-analytical Case-control Study

Introduction: Malaria infection is prevalent in the West African region more than any other region of the continent. To effectively combat this pathology, Seasonal Malaria Chemoprevention (SMC) has been recommended by WHO since 2012. Our objective is to evaluate the extension of seasonal malaria chemoprevention to 5 cycles and to children aged 6 to 9 years in Niger. Method: We conducted an observational case-control study in which we formed two groups for each of the SMC extensions. It took place in the departments of Damagaram Takaya, Takéita and Zinder city town (Zinder region). Children under 5 and those aged 6 to 9, targets of this survey, were randomly selected. The Excel file was used for graphic representations and the SPSS file for coding and analyses. We used descriptive statistics, comparison analyses, chi-square and Fisher tests. Results: The incidence of malaria was 56.5% in children under 5 years of age in the control group compared to 3.5% to 4.5% in children in the intervention group. The extension of SMC to five cycles significantly reduced the risk of malaria infection in children under 5 years by between 72% and 96.4%. It caused 11.8% of side effects in children under 5 years of age and 26% in the range of children aged 6 to 9 years. Conclusions: The extension of SMC to five cycles and to children aged 6 to 9 years significantly reduces malaria incidence among the targeted children. In view of the significant results from the pilot phase, the Niger NMCP can gradually implement the extension of SMC on a national scale.