training manual

Acknowledgements
The SMC toolkit was produced by
Medicines for Malaria Venture (MMV).
MMV gratefully acknowledges the following partners who
contributed to the technical content and development of
the materials (listed in alphabetical order):
Global Malaria Programme/ World Health Organization
Malaria Consortium
Médecins sans frontières
National Malaria Control Programmes (NMCP) of Bénin,
Burkina Faso, Cape Verde, Côte d’Ivoire, The Gambia,
Ghana, Guinea, Guinea Bissau, Liberia, Mali, Mauritania,
Niger, Nigeria, Senegal, Sierra Leone and Togo.
UNICEF
A special thank you to our partners at WARN (West
Africa Regional Network) and CARN (Central Africa
Regional Network) for their strong support throughout
the project.

2
Contents

Introduction5
1 Overview6
1.1 What is SMC? 6

1.2 Where does seasonal malaria occur?  7

1.3 When should SMC be implemented? 7

1.4 A WHO-recommended intervention 8

1.5 Medicines used in SMC 9

1.6 SMC real life experience 10

2 Practical aspects 12
2.1 Who is SMC recommended for? 13

2.2 What: SP+AQ 13

2.3 How is SMC prepared and administered? 13

3 Instructions & key messages for medical staff 14

3.1 Administration of SMC 15

3.2 Adverse events 16

3.3 Key Messages for caregivers (mothers) 19

3.4 Monitoring requirements 20

4 Materials22
4.1 What materials are available 22

4.2 How to use the materials 23

References26

3
 Professor Sir Brian Greenwood, London School of Hygiene and Tropical Medicine

Excitingly, this is something that is available

to put into action immediately,
so children will start to benefit from this
approach now rather than in three or five
years’ time. The key is to ensure that the
promise becomes a reality.

4
 Introduction

This is a comprehensive reference document for use by those running SMC (Seasonal Malaria
Chemoprevention) training. It assumes that SMC will be implemented using a Community Health
Worker strategy.
Each section has the same flow. At the start of each section there is a brief introduction to the
key elements in that section:

In this section you will cover:

0.0 What you will learn

At the end of each section, there is a summary of key points. The summary looks like this:

Key points to remember:

• A key point to remember

Acronyms used:

AE - Adverse Event
AQ - Amodiaquine
CHW - Community Health Worker
ESA - East and Southern Africa
IPT - Intermittent Preventive Treatment
SAE - Serious Adverse Event
SP - Sulfadoxine-Pyrimethamine
WHO - World Health Organization

5
 1 OVERVIEW & EVIDENCE

In this section you will cover:

1.1 What is SMC? 1.4 A WHO-recommended intervention
1.2 Where does seasonal malaria occur? 1.5 Medicines used in SMC
1.3 When should SMC be implemented? 1.6 SMC real life experience

1.1 What is SMC?

In some parts of Africa, malaria transmission occurs primarily during the three or four months of the rainy season.
Around 39 million children under five live in seasonal malaria areas, where an estimated 34 million malaria cases
occur and over 150,000 children die each year. 1
SMC is a preventive intervention focused on children under five living in those areas.
SMC, previously termed “intermittent preventive treatment in children”, is defined as “the intermittent
administration of full treatment courses of an antimalarial medicine during the high malaria season to prevent
malarial illness with the objective of maintaining therapeutic antimalarial drug concentrations in the blood
throughout the period of greatest malarial risk.” 2

SMC benefits
This intervention has been shown to be effective, cost-effective, well tolerated, and feasible for preventing
malaria among children less than 5 years of age in areas with highly seasonal malaria transmission. 2

5 million 20,000 Number of

malaria deaths
Number of malaria that SMC could
episodes that SMC help prevent each
could help prevent year 1
each year 1
25m
children aged 3 - 59 months living
in the Sahel sub-region could
benefit from seasonal malaria
chemoprevention every year 1

of all malaria of severe

75-85% episodes
prevented 1, 2
75-85% malaria episodes
prevented 1, 2

6
1.2 Where does seasonal malaria occur?

Sahel: Benin, Burkina Faso, Guinea,

25 million Guinea-Bissau, Mali, Mauritania,
children Niger, Nigeria, Central African
Republic, Senegal, Sudan, Chad
under 511

ESA:
Angola, Botswana, Malawi,
14 million Democratic Republic of the Congo
children (DRC), Namibia, Northern Mozambique,
under 5 1 Tanzania, Zambia, Zimbabwe

1.3 When should SMC be implemented?

SMC should be given during the high malaria transmission period (rainy season), when the incidence of
malaria is high. 2

The period of SMC administration should be chosen to target the period when children are most at risk of
malaria attacks. 2 Exact start and end dates depend on the patterns of malaria transmission and rainfall,
so can vary within and between countries as well as from one season to the next.

+ =
7
 1 OVERVIEW & EVIDENCE

1.4 A WHO-recommended intervention

Over the past two years, studies have shown that providing healthy children with a monthly course of two
existing malaria medicines (sulfadoxine-pyrimethamine (SP) and amodiaquine (AQ)) during peak transmission
season can prevent about 80% of severe and uncomplicated malaria cases. 1
Researchers estimate that about 5 million cases of malaria and about 20,000 deaths from malaria could be
prevented annually if SMC were fully implemented. 1

20,000 80%
deaths from malaria could be of severe and uncomplicated malaria
prevented annually 1 cases could be prevented each year 1

Based on these impressive results, the World Health Organization has conducted an evidence-based review.
It has subsequently recommended SMC in those countries with seasonal transmission characteristics, and where
the two component drugs are both still effective against Plasmodium falciparum malaria.
For children aged between 3 and 59 months in the Sahel sub-region, WHO recommends a single dose of
SP, plus a three-day course of AQ, once a month, for 3 to 4 months during the malaria season.2

In December 2012, WHO published an SMC Field Guide (implementation manual) to provide malaria-endemic
countries with practical, adaptable and ready-to-use materials for use throughout the intervention, from planning
to monitoring phases. SMC is indicated as part of the malaria control strategies in areas of highly seasonal
malaria transmission. 2
Key interventions currently recommended by WHO for the control of malaria are: the use of long-lasting
insecticidal nets (LLINs) and/or indoor residual spraying (IRS) for vector control, prompt access to diagnostic
testing of suspected malaria and appropriate treatment of confirmed cases with effective artemisinin-based
combination therapy.

SMC: should be used as a malaria control strategy, and not as a malaria elimination strategy.

Additional interventions which are recommended for the prevention of Plasmodium falciparum malaria targeting
specific high risk groups in areas of high transmission include:

1. Intermittent Preventive Treatment in pregnancy (IPTp)

2. Intermittent Preventive Treatment in infants (IPTi)

The changing epidemiology of malaria makes a “one size fits all” approach redundant, and calls for control
strategies targeted at specific populations and/or locations for maximal effectiveness.

8
1.5 Medicines used in SMC
Meta-analysis (pooled data from clinical studies) of 7 SMC studies, where a course of antimalarials was given
periodically to children under 5 years during peak malaria season showed 80% reduction in clinical attacks of
malaria, and a similar reduction in the incidence of severe malaria.3
The SP+AQ combination used in most trials was well tolerated. 1, 2

In field trials testing SMC’s efficacy in protecting children from malaria, and a large-scale effectiveness study
in Senegal, SP+AQ was the preferred drug combination. This was for the following reasons: 2

• In clinical trials, SP+AQ gave greater protection than other drug combinations. The use of the two drugs in
combination limits the risk for selection for resistance to either SP or AQ use as monotherapy.

• Each drug retains its efficacy in areas of Sahel and sub-Sahel with seasonal transmission where
SMC is appropriate.

• The SP+AQ regimen is well tolerated and relatively cheap.

• The combination of SP+AQ does not include artemisinin derivatives. Therefore, artemisinin based
combinations can be reserved for clinical cases where they are most useful.

A review of available data reported no definite case of serious adverse events (SAEs) after more than
80,000 courses of SP+AQ had been administered to more than 30,000 children. However, no active case
detection was done.

80,000
treatments were administered with
no definite case of SAE

9
 1 OVERVIEW & EVIDENCE

1.6 SMC real life experience

In Senegal, SMC, using trained Community Health Workers (CHW), was implemented through the existing
health system. More than 790,000 courses were administered to more than 140,000 children. 2

Key lessons learned: 2

• Regular meetings with regional and district health authorities from the beginning, helped to improve
understanding and trust and created a feeling of ownership at each level.

• The participation of community members in sensitisation and mobilisation built trust between implementers
and the community.

• Providing incentives played a major role in the commitment of CHWs and health personnel during SMC
implementation.

• Access to sufficient funding is important, to help plan and deliver activities and motivate staff.

• Combining SMC with vitamin A and albendazole (for de-worming) or alongside community case management
of malaria showed how SMC can be successfully delivered alongside other health programmes.

• The right period for SMC administration can differ between localities within one country, due to differences in
the pattern of transmission and other local factors.

• Training of all personnel involved is critical. Workshops explained how to recognize, manage and document
adverse drug reactions, and leaflets outlining how to spot adverse reactions to SP or AQ were distributed.
The ideal time to train CHWs is 2-4 weeks ahead of SMC beginning.

SMC has been administered to more than 175,000 children between 3 and 59 months in southern Mali and
in two areas of Chad. 4
• Preliminary results from the programme show that the number of cases of simple malaria dropped by 65% in
the intervention area in Mali, and by up to 86% in Chad. 4
• A significant decrease in cases of severe malaria has also been recorded. 4

10
Key points to remember:

• Community participation and health authority ownership of the SMC

programme should be encouraged.
• Raising awareness of the SMC strategy and its benefits, ahead of
delivery, is vital to avoid misunderstandings and negative perceptions.
• CHWs, supervised by staff from general health services, are the most
efficient SMC delivery channel.
• SMC can be effectively implemented alongside community case
management of malaria and administration of Vitamin A and
albendazole.
• CHWs should be fully trained, to ensure coverage is high for all
treatment cycles and that mothers understand their own role in
administering SMC for each child.

11
 2 Practical aspects

In this section you will cover:

2.1 Who is SMC recommended for?
2.2 What: SP+AQ
2.3 How is SMC prepared and administered?

Children aged
3-59 months

WHO

HOW

Day 1 Day 2 Day 3

WHEN SP

3 - 4 months
during the rainy AQ AQ AQ
season

12
2.1 Who is SMC recommended for?
A complete treatment course of sulfadoxine-pyrimethamine (SP) plus amodiaquine (AQ) should be
given to children aged 3 - 59 months.

IMPORTANT:

SMC should not be given to:

• A child less than 3 months old.
• A child who is sick with uncomplicated or severe malaria at the time of SMC administration.
These children must be referred to a health centre for care using the integrated management of childhood
illness (IMCI) guidelines. Mothers must be advised to bring children back after 30 days for the next round
of SMC treatment.
• An HIV-positive child receiving co-trimoxazole.
• A child with severe acute or chronic illness or unable to take oral medication.
• A child who has received a dose of either SP, ASAQ or AQ or other drugs containing sulfonamide in the
last 30 days. These children should be given an appointment for the next round of treatment.
• A child who is allergic to either drug (SP or AQ).

2.2 What: SP+AQ

WHO recommends that a complete treatment course of amodiaquine plus sulfadoxine-pyrimethamine (AQ+SP)
should be given to children aged between 3 and 59 months at monthly intervals, beginning at the start of the
transmission season, to a maximum of four doses during the malaria transmission season (provided both drugs
retain sufficient antimalarial efficacy).

Loose tablets should be given as replacement doses when a child vomits, spits out or regurgitates the drugs.

• Labelling SMC drug packages in different colours for younger and older children helps mothers administer the
right medication.

Missing one course of treatment does not prevent a child from receiving the next course of SMC drugs,
provided it is not contraindicated for the child to receive SMC.

2.3 How is SMC prepared and administered?

There is no standard delivery system for SMC. The following delivery channels can be used:
• Community-based delivery using:
- Community health workers or community volunteers
- Reproductive and child health (RCH) tracking teams

• Health facility-based delivery

13
 3 Instructions & key messages for m

In this section you will cover:

3.1 Administration of SMC 3.3 Key Messages for caregivers (mothers)
3.2 Adverse events 3.4 Monitoring requirements

14
edical staff

3.1 Administration of SMC

Dose varies depending on age.

AGE DOSAGE DAY 1 DAY 2 DAY 3

A single dose of
250/12.5mg SP SP
on Day 1.
75mg AQ given once AQ AQ AQ
3-11 months on Day 1, 2 and 3.*

A single dose of SP
500/25mg SP
on Day 1.
AQ AQ AQ
150mg AQ given once
12-59 months on Day 1, 2 and 3.

The single dose of SP is given only on the first day together with the first dose of AQ.
Administration of at least the first dose (single dose of SP and the first dose of AQ) must be directly observed.
*Take half tablet of 150mg AQ / 500/25mg SP if strength/dose not available.

This is repeated each month during the transmission season.

It is important to split the tablets carefully when this is required. If the 2 halves are not even,
they must be discarded and not given to children. Most manufacturers produce scored tablets
(tablets with dividing lines) to make it easy to break them into 2 halves for correct dosing.

Intermittent Preventive Treatment with SP in infancy (IPTi) and SMC should not be administered together.
For that reason, IPTi should not be used in SMC target areas. Alternative antimalarial combinations,
containing neither SP nor AQ, must be provided to treat clinical malaria in the target age group.

15
 3 Instructions & key messages for m

What you need

Tablets SP SP
PotableSP
water SP2 clean cups 1 clean spoon Sugar

SP SP
AQ AQ
AQ AQ
AQ AQ

Step-by-step process

Step 1 AQ AQ
3-11 months
1 3
12-59 months 4
AQ AQ
SP 250/12,5mg 2
SP 500/25mg
TakeAQ
one tablet of SP
and one tablet of AQ.AQ
AQ
AQ
AQ 75mg
SP AQ 150mg

AQ
AQ SP AQ SP AQ
5
AQcorrect dose for age ofAQ
1.Use child.

Step 2
1 3 4
6
2. Separately crush SP and AQ
drugs
1
2
3 AQ 4 2

3. Make sure all the powder is

SP
transferred into the cup 5
4. Mixed with clean/potable
water

1 3 4 6
AQ
5. Add sugar to mask the
bitterness of AQ
2

6. Stir
5

Step 3

Give the medicines to the child separately

starting with SP.
For child from 3 to 11 months of age,
use a spoon to administer the medicine.
For the older child, use the cup.

16
edical staff

Step 4 5 minutes

Keep the child under observation

for 5 minutes.

Vomiting No Vomiting
If a child vomits, spits or regurgitates Proceed to
the medicines within 5 minutes, 5 minutes Step 8.
complete the following steps. (Young
children are more likely to vomit).

Step 5

Wait 10 minutes. 10 minutes

Step 8

Step 6 Give to parents/care givers:

• 2 tablets of AQ for Day 2
Give a replacement dose.
and Day 3
• SMC Passport
• Tell them when to come
back next month

Step 7

Keep the child under

observation for a 5 minutes
further 5 minutes.

If a child vomits again, If the child does

do not give replacement not vomit, proceed
dose and alert the to Step 8.
health centre.

17
 3 Instructions & key messages for m

It is vital to give the full treatment course

• Aim to administer three doses per treatment course to each eligible child, three (or four) times during the
high malaria transmission season.

• Children who receive less than three courses or fewer doses per course of treatment are less protected against
clinical malaria, therefore it is important that a child receives full doses of each course of treatment.

• Up to a maximum of four courses may be given yearly, depending on the patterns of malaria transmission.

• If a child misses treatment after the CHW visit, their mother should take them to the health centre in the next
few days to receive SMC. If a child totally misses one treatment course because of illness or absence,
treatment should be given at the next round of SMC, provided the child is present and well.

Missing one course of treatment does not prevent a child from receiving the next course of SMC drugs if
there are no contraindications for the child to do so.

IMPORTANT:

Children who missed SMC doses in a given treatment course showed lower protection against
malaria attacks between the last and the next treatment round.
The length of protection varies, depending on the drug regimen used and the prevailing levels of
resistance to the drug. Therefore, it is important to keep a one month interval between treatment
courses. This creates a high level of protection and minimises the selection for malaria parasites
resistant to SP+AQ.
Treatment of breakthrough Plasmodium falciparum infections during the period of SMC should not
include either SP or AQ, or combination drugs containing either of these medicines, such as AS+AQ.

18
edical staff

3.2 Adverse Events

SMC drugs are well tolerated when
given in standard doses and have
a history of long-time use.
The most common mild adverse
events caused by AQ are vomiting,
abdominal pain, fever, diarrhoea,
itching, headaches and rash.
These generally last for a short Vomiting Mild skin reaction Tummy pain
time. If they become severe, they or Diarrhoea
can be treated symptomatically.
If they become severe, you must
seek medical advice.

Drowsiness Fever Headache

3.3 Key Messages for caregivers (mothers)

• SMC drugs protect children against malaria during the rainy season

• SMC is given to all children aged 3 - 59 months

• SMC is a 3-day course

• The first dose is given by CHW

• 2nd and 3rd doses must be given at home at Day 2 & Day 3

• Treatment must be repeated every month over 3 or 4 months

• There are two different doses depending on the child’s age

• There is one treatment per child

• Do not mix the tablets between children

• Risk of adverse events: explain these to the mother and discuss actions she would take
if a serious event happens

19
 3 Instructions & key messages for m

3.4 Monitoring requirements

The aim is to routinely track essential elements of programme performance through record keeping,
regular reporting, surveillance and periodic surveys.

At the end of the day CHWs must:

count the number of treatment courses that have been given to children

count the number of children who were missed

discard broken tablets

take completed forms back to the health centre

provide brief report to the head nurse

discuss with the nurse what went well or wrong

prepare material for the next day (clean cups, clean spoons, check availability of SMC treatment courses)

At the end of the community round distribution, CHWs should report to the health centre on the number of
treatment courses received, administered and remaining.

Supervision
Intensive supportive supervision should be put in place in the early stages of SMC implementation (first round/
first year) to identify and resolve problems. Supervision should be reduced to the minimum necessary once
SMC delivering staff have acquired some experience. If required, retraining can be offered on site to those
experiencing difficulties. Supervision should be carried out by the NMCP staff, the district medical staff and
nurses at peripheral health centres. Full checklists for this can be found in the WHO Field Guide.

20
edical staff

CHWs will be evaluated by supervisors. In addition, the supervisor should carry out a survey of a random
sample of mothers to assess knowledge about SMC and how well the strategy has been accepted.
This activity should be undertaken during the first round of SMC administration in the first year
and can be repeated every 2-3 years.

Monitoring of adverse drug reactions

Monitoring of adverse drug reactions after administration of SMC drugs is an
important aspect of SMC implementation. Health personnel, CHWs and mothers
should be trained to identify and report adverse events. If CHWs identify serious
or severe adverse events they should report to nurses at the health centre who
will complete the necessary form and send it to the district medical office for
appropriate action to be taken.

Key points to remember:

• The health centre needs to record the number of children with malaria or
fever. It also needs to record whether these children have received SMC
and how many doses of AQ they have taken.
• Coverage will be estimated using the number of children who should
potentially receive SMC as recorded by the CHW and the number of
children who actually receive the complete dose of SMC during each
treatment course for each transmission season. The number of children
who arrive at delivery points but cannot receive SMC should also be
recorded.
• Monitoring of adverse drug reactions is an important aspect of SMC
implementation.
• Health personnel, CHWs and mothers should be trained to identify and
report adverse events. It is important that mothers report all adverse
events, mild or trivial, and know what to do when they see them.
• The CHW must complete all necessary paperwork and reconcile the
number of tablets on a daily basis.

21
 4
Materials

In this section you will learn:

4.1 What materials are available
4.2 How to use the materials

4.1 What materials are available

For CHW For parents For Monitoring Purposes

• Poster / Flyer • SMC Passport • Drug Counting Card

• Clinic Poster • Child Counting Card

• Wristbands • Adverse Events Form

• Register

22
4.2 How to use the materials

For CHW

OFFER YOUR YOUNGER ONES

EXTRA PROTECTION FROM MALARIA
WITH SMC
What is SMC?

© 2014 Developed by Medicines for Malaria Venture (MMV).

Seasonal Malaria Chemoprevention (SMC) is a preventive treatment for malaria.
It is for children from 3 months to 5 years of age.
The medication is given for 3 consecutive days each month during the rainy season.
SMC is supported by the Ministry of Health.

At:

Date:

OFFER YOUR YOUNGER ONES

EXTRA PROTECTION FROM MALARIA
WITH SMC
What is SMC? How does the SMC campaign work? Poster/flyer – for use in
© 2014 Developed by Medicines for Malaria Venture (MMV).

Seasonal Malaria Chemoprevention (SMC) is a ■ A team of community health workers will come

villages and health centre.

preventive treatment for malaria. It is for children to your door.
from 3 months to 5 years of age. ■ They will give the first dose of SMC to your
The medication is given 3 consecutive days each eligible children.
month during the rainy season. SMC is supported
by the Ministry of Health.
■ They will leave behind the doses for Day 2 and
Day 3 so that you can give it to the children. The flyer is same as the
SMC starts on: poster but smaller in size
At:
to facilitate widespread
distribution.

SEASONAL MALARIA CHEMOPREVENTION (SMC) Clinic Poster – for use in

Dosage The parents’ role:
AGE DOSAGE

A single dose of SP
DAY 1 DAY 2 DAY 3 • Feed the child before giving the
medication.
villages and health centre.
A summary of all
250/12.5mg SP on Day 1.

75mg AQ given once

• Give the medicines on Day 2 and
AQ AQ AQ
3-11 months on Day 1, 2 and 3. Day 3 each month during the
campaign.
A single dose of SP

key information.
500/25mg SP on Day 1. • Report any illness following drug
150mg AQ given once AQ AQ AQ administration.
12-59 months on Day 1, 2 and 3.
(1-5 years)

DAY 1 – step by step IMPORTANT

1 Take one tablet of SP and one tablet of AQ.
3-11 months 12-59 months
1.Use correct dose for age of child. SMC should not
SP 250/12,5mg AQ 75mg SP 500/25mg AQ 150mg be given to:
2 2. Separately crush SP and AQ drugs.
6 6
3. Make sure all the powder is transferred 3 4 3 4
into the cup. 1 2 1 2
4. Mixed with potable water. • A child who is less than 3 months
5. Add sugar to mask the bitterness of AQ.
6. Stir. SP AQ or more than 5 years old.
5 5
• A child who has malaria at the time
3 Give the medicines to the child separately 4 Keep the child under observation of the SMC medicines
starting with SP. for 5 minutes.
5 min.
administration.
If your child is between 3 to 11 months,
use a spoon to administer the medicine.
If your child is between 12 months to 5 years, • An HIV-positive child receiving
use a cup to administer the medicine.
co-trimoxazole.

• A child who has received a dose

Vomiting No vomiting of SP and/or AQ in the last 3 weeks.
If the child vomits, spits or regurgitates the medicines Proceed to Step 8.
within 5 minutes, complete the following steps.
(Young children are more likely to vomit).
• A child who is allergic to SP and/or
AQ.

5 Wait 10 minutes. 8 • A child who can’t swallow

10 min.
Give to parents/care givers: the medicine even after crushing
• 2 tablets of AQ for Day 2 and Day 3 the tablet.
6 Give a replacement dose. • SMC Passport
• Tell them when to come back next month

The SMC passport

7 has to be given during
Keep the child under observation for a further 5 minutes.
the parents’ first visit.
5 min. It contains information
for the correct use of
SP ORT
SMC
PA S the treatment for the
name:
following days once
back home.
Child’s
/
of the name: /
Head ’s :
Date
household

Vomiting
Age :

No vomiting
If the child vomits again, If the child does

Wristband – for CHW to engage child

do not give replacement not vomit, proceed
dose and seek medical to Step 8.
advice.

with messaging around taking tablets

Adverse Events (AE)
The most common mild adverse events
caused by AQ are vomiting, abdominal
pain, fever, diarrhoea, itching, headaches

on Days 2 & 3. Brightly coloured.

and rash.
These generally last for a short time.

4th
If they become severe, you must seek
for medical advice. . Come back on:
Vomiting Mild skin reaction Tummy pain or Diarrhoea Drowsiness Fever Headache

© 2013 developped by Medicines for Malaria Venture (MMV).

They get a different coloured band for
4th August
Come back on:
Revenir le :

each cycle to help with compliance.

Revenir le : 4 A

23
24
JOUR JOUR

1 2 3
Each day:

4
For parents
DAY 1 DAY 2 DAY 3 DAY 1 DAY 2 DAY 3
• Write the date.
GIVEN BY GIVEN BY
• Tick the box corresponding to GIVEN BY GIVEN BY
HEALTH MOTHER Put your child state. HEALTH MOTHER Put
WORKER your stickers WORKER your stickers
here • Add the sticker on the card here
once the treatment completed
(Day 2+Day 3).
DATE DATE DATE DATE DATE DATE
MONTH
Well reported
tolerated side effects
1

MONTH 1
the child may experience.
DATE DATE DATE
MONTH

2 DATE DATE DATE

DATE DATE DATE

MONTH 2
MONTH

3
DATE DATE DATE
DATE DATE DATE
MONTH
information for parents. It has a clear visual
SMC Passport – This booklet contains key

MONTH 3
Logos partenaires
4
Materials

© 2014 Developped by Medicines for Malaria Venture (MMV).

the importance of completing the full SMC course
(i.e., Day 2 and Day 3) and the adverse events that
schematic illustrating the dosing schedule, stressing

Age :

Age :
Head of the
Child’s name:

Head of the
household’s name:

child’s name:

household’s name:
Date :
/
/

Date :
S M C PA S S P O R T

/
/
s m c PA s s P o r T
S M C
For monitoring

Drug counting card –

Name
DRUG COUNTING CARD Role simple form to manage
Date

Village / area
Zone

Health center
District
number of doses of
Treatment period (tick as appropriate) Month 1 Month 2

This form has to be filled in by the community health worker after each household visit and be given back to the
Month 3 Month 4
drug given and vs stock
health center.
Exemple:
Number of SMC tablets… 1 0 0 2 0 0 inventory. Helps with drug
returns.
All Children aged 3-59 months SP AQ
© 2013 Developped by Medicines for Malaria Venture (MMV).

Name
Number of SMC tablets received
CHILD COUNTING CARD Role
Number of SMC tablets used

Number of SMC tablets remaining Zone District Village / area Health center
Comments
Date Treatment period (tick as appropriate) Month 1 Month 2 Month 3 Month 4
This form has to be filled in by the community health worker after each household visit and be given back to the health center.

Child counting card

OBJECTIF: count the number of children receiving and not receiving the treatment and the reason why not. Use one form by distribution cycle.

Number of children Number of children

Name
DRUG COUNTING CARD
Household Number of children Reason why not
treated who were not treated

Role

– used by CHW to
3-11 months
Household 1 The child has taken as or aq over the last 2 weeks.
12-59 months
Date Zone District

complete as child goes

3-11 months
Village / area Health center
12-59 months

Treatment period (tick as appropriate) Month 1 Month 2 Month 3 Month 4

through SMC cycles.

3-11 months
This form has to be filled in by the community health worker after each household visit and be given back to the
12-59 months
health center.
Exemple:
1 0 0 2 0 0 3-11 months

Used for reporting

Number of SMC tablets …
12-59 months
All Children aged 3-59 months SP AQ
© 2013 Developped by Medicines for Malaria Venture (MMV).

© 2013 Developped by Medicines for Malaria Venture (MMV).

3-11 months

and managing vs
Number of SMC tablets received
12-59 months
Number of SMC tablets used
3-11 months

target population in
Number of SMC tablets remaining
12-59 months

Comments
Total = Total = Total =

implementation plan.

DRUG ADVERSE Name

EVENTS FORM Role

Date

District Village/ Health

area Center

PATIENT INFORMATION Date

of Birth
Nom : or Age:

Sex: M: F: Registration number: Weight:

Name of attending physician:

Register – to record Medical History:

SMC TREATMENT REGISTER Name of RMC responsible

DOOR-TO-DOOR DELIVERY Name of Supervisor responsible

names of all children
ADVERSE EVENT DETAILS

District Village Health center

given SMC. Tick the relevant box to show which event(s) the child has suffered from and write in the date
of the adverse event.
Vomiting Mild skin Tummy pain Description
reaction or Diarrhoea of event:
Household SMC 1 SMC 2 SMC 3 SMC 4
Registration number Child name AGE SEX Delivery Reason AE * Ref. Delivery Reason AE * Ref. Delivery Reason AE * Ref. Delivery Reason AE * Ref.
date NOT date NOT date NOT date NOT
Given Given Given Given Date of Date of Date of
Code Code Code Code
3 12
- -
12 59 M F dd | mm | yy A S D DNA Y N Y N dd | mm | yy A S D DNA Y N Y N dd | mm | yy A S D DNA Y N Y N dd | mm | yy A S D DNA Y N Y N
onset onset onset

Drowsiness Fever Headache

Date of Date of Date of

onset onset onset

Adverse Events To be completed by the Chief District Medical.

© 2014 Developped by Medicines for Malaria Venture (MMV).

form – for every AE ACTIONS TAKEN

Traitement : No: Yes:
Follow up:
Hospitalisation:
Other:
© 2013 Developped by Medicines for Malaria Venture (MMV).

Specify: Follow up:

reported, must be SMC DETAILS Months Number: Batch No :

Date Given: 1 2 3 4 Expiry Date:

filled in and returned

to the health centre.
Code for reason SMC was not given: A = allergy S = fever or sick child D = taken AQ, SP or Sulfa DNA = did not attend AE = Adverse Events

Key points to remember:

• There is a full range of materials available to help with all aspects of

successful SMC implementation.
• Help mothers understand and remember what they need to do.

25
 Notes
references

1 Cairns, M. et al. Estimating the potential public health impact of seasonal malaria chemoprevention
in African children. Nat. Commun. doi:10.1038/ ncomms1879 (2012)

2 World Health Organisation. Seasonal Malaria Chemoprevention with sulfadoxine-pyrimethamine

plus amodiaquine in children - a field guide. July 2013.
ISBN: 9789241504737 [viewed 23 September 2013].
Available from
http://www.who.int/malaria/publications/atoz/9789241504737/en/

3 Meremikwu, M. M., Donegan, S., Sinclair, D., Esu, E. & Oringanje, C.

Intermittent preventive treatment for malaria in children living in areas with seasonal transmission.
Cochrane Database Syst. Rev. 2, CD003756 (2012)

4 Doctors Without Borders/Médecins Sans Frontières (MSF). Press release, 24 September 2012.
Novel Program Shows Strong Promise in Malaria Prevention. [viewed 23 September 2013].
Available at
http://www.doctorswithoutborders.org/press/release.cfm?id=6319

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Notes

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© 2013 Materials developed by Medicines for Malaria Ventures (MMV).