The study aims to test the feasibility, effectiveness and chemoprevention efficacy of SMC with SPAQ in an area of Mozambique where malaria transmission is highly seasonal.
This implementation research study uses a convergent mixed-methods approach. SMC will be implemented in four monthly cycles between November 2021 and February 2022. The research will involve seven components:
1. Documenting the process of further adapting the intervention to the context in Mozambique
2. Conducting a representative end-of-round household survey to determine coverage and quality of SMC implementation
3. Conducting a cluster randomized controlled trial (cRCT) through passive surveillance to establish confirmed malaria cases in children
4. Conducting a prospective chemoprevention efficacy cohort study to determine if SPAQ provides 28 days of protection from infection and whether drug concentrations and/or resistance influence the duration of protection
5. Conducting a resistance markers study in children 3–59 months in the two research districts plus the two standard intervention districts to measure changes in resistance marker prevalence over time
6. Modelling the protective effect of SPAQ in Mozambique using existing data from phase 1 to determine where SMC could be a suitable malaria prevention strategy
7. Conducting a process evaluation of the SMC implementation.