TY  - JOUR
AU  - Wharton-Smith, Alexandra
AU  - Baker, Kevin
AU  - Roca-Feltrer, Arantxa
AU  - Rodrigues, Maria
AU  - Richardson, Sol
AU  - Bonnington, Craig A
AU  - Rassi, Christian
AU  - Marasciulo, Madeleine
AU  - Enosse, Sonia
AU  - Saute, Francisco
AU  - Aide, Pedro
AU  - Macete, Eusebio
AU  - Candrinho, Baltazar
PY  - 2021
DA  - 2021/9/15
TI  - Assessment of the Feasibility, Acceptability, and Impact of Implementing Seasonal Malaria Chemoprevention in Nampula Province, Mozambique: Protocol for a Hybrid Effectiveness-Implementation Study
JO  - JMIR Res Protoc
SP  - e27855
VL  - 10
IS  - 9
KW  - malaria
KW  - seasonal malaria chemoprevention
KW  - sulfadoxine-pyrimethamine amodiaquine
KW  - resistance
KW  - children under five
KW  - implementation research
KW  - Mozambique
KW  - Africa
KW  - mobile phone
AB  - Background: Malaria is a significant cause of morbidity and mortality in children aged under 5 years in Mozambique. The World Health Organization recommends seasonal malaria chemoprevention (SMC), the administration of four monthly courses of sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ), to children aged 3-59 months during rainy season. However, as resistance to SP is widespread in East and Southern Africa, SMC has so far only been implemented across the Sahel in West Africa. Objective: This protocol describes the first phase of a pilot project that aims to assess the protective effect of SP and AQ when used for SMC and investigate the levels of molecular markers of resistance of Plasmodium falciparum to antimalarial medicines in the study districts. In addition, it is important to understand whether SMC is a feasible and acceptable intervention in the context of Nampula Province, Mozambique. Methods: This study will adopt a hybrid effectiveness-implementation design to conduct a mixed methods evaluation with six objectives: a molecular marker study, a nonrandomized controlled trial, an analysis of reported malaria morbidity indicators, a documentation exercise of the contextual SMC adaptation, an acceptability and feasibility assessment, and a coverage and quality assessment. Results: Ethical approval for this study was granted by the Mozambican Ministry of Health National Bioethics Committee on September 15, 2020. Data collection began in October 2020, and data analysis is expected to be completed by August 2021. Conclusions: This research will make a unique contribution to our understanding of whether the combination of SP and AQ, when used for SMC, can confer a protective effect against malaria in children aged 3-59 months in a region where malaria transmission is seasonal and SP resistance is expected to be high. If the project is successful, subsequent phases are expected to provide a more comprehensive assessment of the effectiveness and sustainability of SMCs. International Registered Report Identifier (IRRID): DERR1-10.2196/27855 
SN  - 1929-0748
UR  - https://www.researchprotocols.org/2021/9/e27855
UR  - https://doi.org/10.2196/27855
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34524109
DO  - 10.2196/27855
ID  - info:doi/10.2196/27855
ER  -