New efforts to prevent deaths from one of the world's most widespread diseases could help save tens of thousands of young lives every year, researchers have said.
Scientists at the London School of Hygiene and Tropical Medicine (LSHTM) working in the UK and Africa say giving children a monthly medicine would protect them against malaria, a mosquito-borne disease which is thought to affect almost half of the world's population and is particularly rife during rain season.
The research into seasonal malaria chemoprevention (SMC) focused on Africa where the disease is most prevalent. It discovered that regular medicine could mean around 11 million cases of malaria and approximately 50,000 deaths could be prevented every year if SMC was fully implemented.
Dr Matt Cairns, of the LSHTM, said: "We have identified two large areas of Africa where monthly [SMC] could be an effective addition to existing approaches that reduce exposure to mosquitoes. If this control measure could be deployed widely it could prevent many millions of cases of malaria and tens of thousands of deaths every year."
Malaria is caused by mosquito bites, with symptoms typically taking up to a fortnight to show. They can include fevers, vomiting and other flu-like symptoms, and can be deadly if not caught and treated at an early stage.
Children are particularly susceptible to the disease, which is estimated to cause more than 200 million illnesses and contributes to an estimated 655,000 deaths around the globe every year.
The study is published on the Nature Communications website today and shows that in some parts of Africa, malaria is only a major problem for a few months of the year during and immediately after the rainy season.
In these areas, providing monthly courses of a cheap, anti-malarial drug combination to young children during the malaria transmission season when they are at highest risk has been shown to prevent approximately 80% of severe and uncomplicated cases.
Currently, anti-insecticides and bed nets are the main deterrent used in the fight against the disease in Africa.
But researchers say regular courses of medicine - which are given to foreign travellers visiting the continent - are likely to offer greater protection, particularly in the young.
Dr Cairns added: "Providing insecticide-treated nets is an important way of protecting children from malaria, but in some areas it isn't enough - children need additional methods of protection."
Combining satellite maps of rainfall with information on the malaria burden in different areas of Africa, the researchers identified the regions where seasonal malaria chemoprevention would be useful and cost-effective.
The largest impact would be in countries of the Sahel and sub-Sahel, a wide-belt of Africa ranging from Gambia and Senegal in the west to Sudan in the east.
Key countries are Nigeria, Niger, Burkina Faso and Mali, where approximately 14 million children aged under five are at risk in areas suitable for the SMC approach.
The team also estimated that 40 million children under five living in parts of Africa suitable for SMC could benefit from this intervention and prevent around 150,000 childhood deaths from malaria each year.
Professor Sir Brian Greenwood, one of the senior authors of the study at the LSHTM and a leading expert on malaria control, said: "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."