[Adherence to the second and third doses of seasonal malaria chemoprevention among children aged 3 to 59 months and 6-9 years in the commune of Guidimouni, Niger].

Introduction: seasonal malaria chemoprevention (SMC) is an effective strategy to prevent malaria. In 2022, Niger's national malaria control program expanded SMC to include children aged 6 to 9 years, increasing the regimen to five cycles. The objective of this study was to determine factors influencing adherence to the second and third doses of SMC within the context of its extension to Guidimouni, Zinder.

Methods: focus groups were held with nannies; community relays and in-depth interviews were conducted with caregivers and administrative and customary authorities. Interviews were recorded and transcribed, those in local languages were translated into French and the transcriptions analyzed using N'Vivo software.

Results: in total, nine focus groups and six individual interviews were conducted. SMC and its extension were widely accepted as a key preventive measure. Adherence to SMC among parents of children aged 3-5 and 6-9 years appeared to be generally good, indicating compliance with the second and third doses. The main factors influencing adherence included poor application of administration guidelines, the use of SMC drugs to treat other illnesses, withholding a significant portion of the medication, which can impact the threshold dose required for prevention, and the perception of SMC as a curative rather than preventive treatment for malaria. The prevalence of malaria among children under 5 years and those over 10 years was 32.03% and 35.68% respectively in 2019; 46.76% and 37.11% in 2020, 53.07% and 49.09% in 2021, 51.93% and 45.92% in 2022. Malaria cases within these age groups in the village of Guidimouni continued to rise, with a high prevalence in the community despite seasonal malaria chemoprevention efforts.

Conclusion: it is crucial to strengthen awareness and education efforts for parents regarding the correct administration of SMC.