Effectiveness of seasonal malaria chemoprevention at scale in west and central Africa: an observational study – User Guide

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This collection contains data collected as part of the SMC coverage surveys, case control studies, malaria incidence at health facilities, and molecular markers of resistance, as well as the accompanying protocols, reports, and tools produced by the Access-SMC study. Please consult the file listing for further information.

Study description

Seasonal malaria chemoprevention (SMC) aims to prevent malaria in children during the high malaria transmission season. The Achieving Catalytic Expansion of SMC in the Sahel (ACCESS-SMC) project sought to remove barriers to the scale-up of SMC in seven countries in 2015 and 2016. We evaluated the project, including coverage, effectiveness of the intervention, safety, feasibility, drug resistance, and cost-effectiveness. For this observational study, we collected data on the delivery, effectiveness, safety, influence on drug resistance, costs of delivery, impact on malaria incidence and mortality, and cost-effectiveness of SMC, during its administration for 4 months each year (2015 and 2016) to children younger than 5 years, in Burkina Faso, Chad, The Gambia, Guinea, Mali, Republic of the Niger, and Nigeria. SMC was administered monthly by community health workers who visited door-to-door. Drug administration was monitored via tally sheets and via household cluster-sample coverage surveys. Pharmacovigilance was based on targeted spontaneous reporting and monitoring systems were strengthened. Molecular markers of resistance to sulfadoxine–pyrimethamine and amodiaquine in the general population before and 2 years after SMC introduction was assessed from community surveys. Effectiveness of monthly SMC treatments was measured in case-control studies that compared receipt of SMC between patients with confirmed malaria and neighbourhood-matched community controls eligible to receive SMC. Impact on incidence and mortality was assessed from confirmed outpatient cases, hospital admissions, and deaths associated with malaria, as reported in national health management information systems in Burkina Faso and The Gambia, and from data from selected outpatient facilities (all countries). Provider costs of SMC were estimated from financial costs, costs of health-care staff time, and volunteer opportunity costs, and cost-effectiveness ratios were calculated as the total cost of SMC in each country divided by the predicted number of cases averted.

Description of data capture

Coverage surveys: household survey questionnaires Case control studies: questionnaires Molecular marker surveys: survey questionnaires and lab data Impact: health facility data on confirmed malaria cases from clinic registers.


Seasonal Malaria Chemoprevention, Sahel, ACCESS-SMC


The research study took place between 1 January 2014 - 31 May 2021

Survey work was undertaken during 2015 and 2016. Please consult project documentation (listed below) for information on specific survey work.

Files were submitted to the LSHTM repository on 25 March 2021.

Participating Institutions

The following organisations collaborated on the study:

Project Information

Project title Project funder Grant number Funder URI
ACCESS-SMC UNITAID Unspecified https://unitaid.org/

Publications associated with this item

File description

ACCESS-SMC Evaluation Reports

Filename Description Date File format
ACCESS-SMC_Coverage_Report Seasonal malaria chemoprevention coverage in seven West African countries, 2015-2016. ACCESS-SMC evaluation: final report June 2018 Adobe PDF 1.5
ACCESS-SMC_Drug_Resistance_Baseline_Report Assessment of the frequency of molecular markers associated with resistance to SP+AQ in seven countries before scaling up of seasonal malaria chemoprevention. - Adobe PDF 1.5
ACCESS-SMC_Drug_Resistance_Surveys_Report Assessment of the frequency of molecular markers associated with resistance to SMC drugs in 7 countries after two years of SMC at scale. February 10 2020 Adobe PDF 1.5
ACCESS-SMC_Efficacy_Report Assessment of the protective efficacy of Seasonal Malaria Chemoprevention with sulfadoxine-pyrimethamine plus amodiaquine in Burkina Faso, Chad, The Gambia, Mali and Nigeria, 2015-2016. - Adobe PDF 1.5
ACCESS-SMC_Impact_Report Assessment of the impact of ACCESS-SMC on malaria cases and deaths in 2015 and 2016 - Adobe PDF 1.5
ACCESS-SMC_Safety_Monitoring_Report Monitoring the safety of Seasonal Malaria Chemoprevention during large scale implementation through the ACCESS-SMC project. 2015-16 - Adobe PDF 1.5


Filename Description Date File format
SMC_Evaluation_Protocol_v1.6 ACCESS-SMC Evaluation Protocol v1.6 June 2017 Adobe PDF 1.5
LSHTM_approval_2015-08 LSHTM Observational / Interventions Research Ethics Committee approval letter 11 August 2015 Adobe PDF 1.5
LSHTM_approval_2017-08 LSHTM Observational / Interventions Research Ethics Committee approval letter 9 August 2017 Adobe PDF 1.5


Filename Description Date File format
HFW_SAE_JobAid_Revised_2016_English_PM.pdf Job aids for Pharmacovigilance. Safety monitoring for SMC: Guide to the rare severe side-effects of SMC drugs (English language). 2016 Adobe PDF 1.5
HFW_SAE_JobAid_Revised_2016_French_PM.pdf Job aids for Pharmacovigilance Surveillance de l’inocuité des médicaments de la CPS : Guide pour les effets secondaires graves et rares (French language) 27 June 2016 Adobe PDF 1.5
smc_cov_2020_v05.xls Open Data Kit questionnaire for coverage surveys v0.5 2020 MS Excel .xls
SMC_Case_Control_Study_SOP-2020-10_PM.docx Standard Operating Procedures for SMC case control studies Oct 1 2020 MS Word .docx


The following datasets were collected by the ACCESS-SMC research team for analysis within the study. They are held in the LSHTM repository for preservation purposes only. Please contact the study team directly to discuss datasets produced in the study.

Filename Description File format
case_control_data The ACCESS-SMC Case Control dataset consists of 8 data tables: (1) burkinafaso_cc2016, (2) chad_cc2016, (3) gambia_cc2015, (4) gambia_cc2016, (5) mali_cc2015, (6) mali_cc2016, (7) nigeria16, and (8) nigeria2016. Comma Separated Values
Coverage_survey_data The ACCESS-SMC Coverage survey datasets contain 14 data tables associated with the 2015 and 2016 surveys. These cover The Gambia, Guinea, Mali, Burkina Faso, Republic of the Niger, Nigeria, and Chad. Comma Separated Values
Impact_data Data associated with the impact assessment of ACCESS-SMC on malaria cases and deaths in 2015 and 2016. It consists of 8 data tables that cover Burkina Faso, Chad, The Gambia, Guinea, Mali, Republic of the Niger, and Nigeria.   Comma Separated Values
molecular_markers_dataset Data associated with the molecular markers survey. This consists of one data table Comma Separated Values