Seasonal Malaria Chemoprevention (SMC), which combines amodiaquine (AQ) with
sulfadoxine-pyrimethamine (SP), is an effective and promising strategy,
recommended by WHO, for controlling malaria morbidity and mortality in areas of
intense seasonal transmission. Despite the effectiveness of this strategy, a
number of controversies regarding the impact of the development of
malaria-specific immunity and challenges of the strategy in the context of
increasing and expanding antimalarial drugs resistance but also the limited
coverage of the SMC in children make the relevance of the SMC questionable,
especially in view of the financial and logistical investments. Indeed, the
number of malaria cases in the target group, children under 5 years old, has
increased while the implementation of SMC is been extended in several African
countries. This ambivalence of the SMC strategy, the increase in the prevalence
of malaria cases suggests the need to evaluate the SMC and understand some of
the factors that may hinder the success of this strategy in the implementation
areas. The present review discusses the impact of the SMC on malaria morbidity,
parasite resistance to antimalarial drugs, molecular and the immunity affecting
the incidence of malaria in children. This approach will contribute to improving
the malaria control strategy in highly seasonal transmission areas where the SMC
is implemented.

amodiaquine; immunity; resistance; seasonal malaria chemoprevention; sulfadoxine-pyrimethamine.