Study of the coverage and the impact of the chemoprevention of seasonal malaria in Niger from 2013 to 2022: systematic review

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Purpose Malaria remains a public health problem in Niger, especially among children under the age of five. To combat this scourge, since 2012, the World Health Organization (WHO) has recommended seasonal malaria chemoprevention (SMC), a strategy based on the administration of sulfadoxine-pyrimethamine and amodiaquine (SP-AQ) during the period of high transmission. This systematic review assesses the coverage, efficacy, and challenges of SMC in Niger between 2013 and 2022, analyzing its impact on malaria morbidity and mortality. Materials and methods The PRISMA guidelines were used to ensure a rigorous and comprehensive recording of the systematic review process. Through searches in five different databases, articles were imported into Zotero software, then transferred to the Covidence application, where data processing was carried out. The selected articles were independently evaluated by two reviewers. These included studies that assessed coverage, malaria incidence, and the impact of SMC. Studies published in French and English were included. Data extraction from the included studies was performed, and a quality assessment was conducted, including an evaluation of the risk of bias. Results Among the six studies, three assessed SMC coverage in all eight regions of Niger while also evaluating side effects. They showed high overall coverage but low coverage in some areas. Another study examined the impact in terms of the incidence of complicated malaria, malaria-related hospitalization, and mortality. Another publication revealed that antibody responses against the blood and pre-erythrocytic stages of P. falciparum were higher in the area where SMC was implemented. Conclusions This study demonstrates that SMC has a significant impact on reducing malaria incidence. Although there is high overall coverage, variations exist, particularly in hard-to-reach areas. Few adverse events were reported. However, very few studies are available, highlighting the need for additional research in Niger to better understand this strategy.

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