1Malaria kills, particularly children under the age of five. In the absence of vaccine, these children are not easy to protect at birth and as they grow up in malaria endemic areas. For a long time the preferred option was to administer a very stringent preventive treatment children had to take every day, which was not easy… or relevant in the long term, as this approach induced the emergence of resistance. Furthermore, a full year of therapy seems unnecessary in the Sahel region, where the risk of malaria transmission is seasonal, as the malaria-carrying mosquito is only present from September to November.

Flooding resulting in the development of larval habitats for anopheline mosquitoes, Dakar, Senegal.

2In the 2000s, this situational analysis prompted researchers to devise a more suitable intermittent treatment. They readjusted the protocol in force for pregnant women and infants, and tested it in Senegal on 1,200 children in 2002 and 2,000 children in 2004. By doing this, they showed that taking one to three doses of artesunate and sulfadoxine-pyrimethamine within one month of each other during the peak transmission period helps reduce the risk of infection in children under the age of five by 86%, without causing any serious side effects. From 2008 to 2010, a larger-scale assessment was carried out on some 200,000 Senegalese children. This protocol was strictly adhered to and helped reduce the percentage of infected children from 30-40% to 2%.

3It was such a success that this intermittent approach, referred to as seasonal malaria chemoprevention, has been recommended since 2012 by the World Health Organisation. It is currently implemented in the Sahel as well as all regions where at least 60% of transmission cases occur over a four-month period, with a view to protecting more than 34 million children under the age of five. This preventive approach is now a priority of the national malaria control plans of several countries.

Distribution of a treatment to prevent malaria, Niakhar, Senegal.