{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T20:01:08Z","timestamp":1772740868029,"version":"3.50.1"},"reference-count":86,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    After the expansion of the World Health Organization\u2019s guidelines on eligibility for the seasonal malaria chemoprevention (SMC), the government of Kenya prepared to implement SMC for a first time in Turkana Central Subcounty in 2024. To inform the design of SMC, we conducted a baseline qualitative and quantitative study. Using stratified cluster sampling, we enrolled 198 households with children of ages 6 months to 5 years and tested all individuals six months and older using a rapid diagnostic test (RDT) and polymerase chain reaction (PCR) for\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    . We performed 78 key informant interviews; 31 focus group discussions with community health workers, elders, and caretakers of children; and 60 in-depth interviews with caretakers. Prevalence of\n                    <jats:italic>P. falciparum<\/jats:italic>\n                    infection was 21% (9\u201342%) by RDT and 21% (11\u201338%) by PCR. Prevalence varied across villages, with the highest positivity of 73% by PCR. Although SMC was perceived positively, the identified challenges included physical access (households far from village centers, pastoralists, children living in the streets), stigma (children living with disabilities, households with members struggling with alcohol use), and acceptability (traditionalists, highly educated households). Despite the high malaria burden in the region, SMC may be a feasible approach to reduce its burden and transmission. However, implementation of SMC should be tailored, combining centralized distribution with door-to-door delivery and outreach to pastoralists and people living in the interior. Using existing grassroots structures, such as pastoralist leadership structures and religious and group leaders, and intensive mobilization will be critical for success of this intervention.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.24-0832","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T16:51:11Z","timestamp":1767113471000},"page":"466-480","source":"Crossref","is-referenced-by-count":0,"title":["A Baseline Mixed\u2013Methods Study to Inform Seasonal Malaria Chemoprevention Delivery in a Semi-Nomadic Population in Turkana, Kenya"],"prefix":"10.4269","volume":"114","author":[{"given":"Natalya","family":"Kostandova","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Kafu","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access to Health Care, Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tabitha J.","family":"Chepkwony","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access to Health Care, Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Ambani","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access to Health Care, Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucy","family":"Abel","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access to Health Care, Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatrice","family":"Rotich","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access to Health Care, Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Kipkoech Kirui","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access to Health Care, Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmah","family":"Kimachas","sequence":"additional","affiliation":[{"name":"Academic Model Providing Access to Health Care, Eldoret, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Robie","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaman","family":"Lowoi","sequence":"additional","affiliation":[{"name":"Duke Global Inc, Nairobi, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Ekai","sequence":"additional","affiliation":[{"name":"Turkana County Ministry of Health, Lodwar, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gilchrist","family":"Lokoel","sequence":"additional","affiliation":[{"name":"Turkana County Ministry of Health, Lodwar, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omalo","family":"Orinda","sequence":"additional","affiliation":[{"name":"Catholic Relief Services, Nairobi, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Van Hulle","sequence":"additional","affiliation":[{"name":"Catholic Relief Services, Nairobi, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Mgeni","sequence":"additional","affiliation":[{"name":"Catholic Relief Services, Nairobi, Kenya;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy Prudhomme","family":"O\u2019Meara","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Wesolowski","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Becky","family":"Genberg","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Menya","sequence":"additional","affiliation":[{"name":"Moi University School of Public Health, Eldoret, Kenya"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","article-title":"World Malaria Report 2022.","year":"2022"},{"key":"b2","article-title":"WHO Policy Recommendation: Seasonal Malaria Chemoprevention (SMC) for Plasmodium falciparum Malaria Control in Highly Seasonal Transmission Areas of the Sahel Sub-Region in Africa.","year":"2012"},{"key":"b3","article-title":"Global Technical Strategy for Malaria 2016\u20132030, 2021 Update.","year":"2021"},{"key":"b4","article-title":"Updated WHO Recommendations for Malaria Chemoprevention and Elimination.","year":"2022"},{"key":"b5","series-title":"Cochrane Database Syst Rev","first-page":"CD003756","article-title":"Chemoprophylaxis and intermittent treatment for preventing malaria in children","volume":"2","author":"Meremikwu","year":"2008"},{"key":"b6","series-title":"Am J Trop Med Hyg","first-page":"20","article-title":"Systematic review and meta-analysis of seasonal malaria chemoprevention","volume":"110","author":"Thwing","year":"2024"},{"key":"b7","series-title":"PLoS One","first-page":"e0193296","article-title":"Optimal mode for delivery of seasonal malaria chemoprevention in Ouelessebougou, Mali: A cluster randomized trial","volume":"13","author":"Barry","year":"2018"},{"key":"b8","series-title":"PLoS One","first-page":"e32900","article-title":"Intermittent preventive treatment of malaria in children: A qualitative study of community perceptions and recommendations in Burkina Faso and Mali","volume":"7","author":"Pitt","year":"2012"},{"key":"b9","series-title":"PLoS One","first-page":"e7256","article-title":"Options for the delivery of intermittent preventive treatment for malaria to children: A community randomised trial","volume":"4","author":"Kweku","year":"2009"},{"key":"b10","article-title":"WHO Consolidated Guidelines for Malaria.","year":"2023"},{"key":"b11","article-title":"The Epidemiology and Control Profile of Malaria in Kenya: Reviewing the Evidence to Guide the Future Vector Control.","author":"Noor","year":"2016"},{"key":"b12","series-title":"Am J Trop Med Hyg","first-page":"1076","article-title":"Epidemiology of Plasmodium falciparum infections in a semi-arid rural African setting: Evidence from reactive case detection in Northwestern Kenya","volume":"105","author":"Meredith","year":"2021"},{"key":"b13","series-title":"PLOS Glob Public Health","first-page":"e0000807","article-title":"Plasmodium falciparum importation does not sustain malaria transmission in a semi-arid region of Kenya","volume":"2","author":"Markwalter","year":"2022"},{"key":"b14","article-title":"Turkana County SMART Nutrition Surveys.","year":"2019"},{"key":"b15","series-title":"PLOS Glob Public Health","first-page":"e0002750","article-title":"Characterizing mobility patterns and malaria risk factors in semi-nomadic populations of Northern Kenya","volume":"4","author":"Meredith","year":"2024"},{"key":"b16","article-title":"Turkana County: County Integrated Development Plan, CIDP II 2018\u20132022.","year":"2018"},{"key":"b17","article-title":"Turkana County Kicks off Measles Vaccination Campaign \u2013 Kenya News Agency.","author":"Gitonga","year":"2023"},{"key":"b18","article-title":"Turkana Children to be Vaccinated against Polio.","author":"Etyang","year":"2019"},{"key":"b19","series-title":"Ethn Health","first-page":"817","article-title":"Planning and implementing a targeted polio vaccination campaign for Somali mobile populations in Northeastern Kenya based on migration and settlement patterns","volume":"27","author":"Harvey","year":"2022"},{"key":"b20","article-title":"New Malaria Prevention Strategy, \u2018SMC\u2019 Set to Reduce Malaria Related Deaths among Children in Turkana \u2013 Turkana County Government.","year":"2024"},{"key":"b21","series-title":"PLoS Negl Trop Dis","first-page":"e0008474","article-title":"Health services uptake among nomadic pastoralist populations in Africa: A systematic review of the literature","volume":"14","author":"Gammino","year":"2020"},{"key":"b22","series-title":"BMC Med","first-page":"172","article-title":"Leaving no one behind: Targeting mobile and migrant populations with health interventions for disease elimination\u2014A descriptive systematic review","volume":"20","author":"Adams","year":"2022"},{"key":"b23","series-title":"Front Trop Dis","first-page":"1007480","article-title":"Challenges and strategies for the uptake of mass drug administration among pastoralist communities in South Sudan","volume":"4","author":"Muchiri","year":"2023"},{"key":"b24","series-title":"Trop Med Int Health","first-page":"1332","article-title":"Health interventions among mobile pastoralists: A systematic review to guide health service design","volume":"25","author":"Wild","year":"2020"},{"key":"b25","series-title":"A Concise Introduction to Mixed Methods Research","author":"Creswell","year":"2014"},{"key":"b26","series-title":"J Stat Softw","first-page":"1","article-title":"Analysis of complex survey samples","volume":"9","author":"Lumley","year":"2004"},{"key":"b27","series-title":"R: A Language and Environment for Statistical Computing","year":"2022"},{"key":"b28","series-title":"RStudio: Integrated Development Environment for R","year":"2023"},{"key":"b29","article-title":"ATLAS.ti Scientific Software Development GmbH.","year":"2023"},{"key":"b30","article-title":"NVivo.","year":"2014"},{"key":"b31","series-title":"A Practical Guide to Conducting a Barrier Analysis","author":"Kittle","year":"2013"},{"key":"b32","series-title":"Vaccines (Basel)","first-page":"214","article-title":"Behavioural determinants of COVID-19-vaccine acceptance in rural areas of six lower- and middle-income countries","volume":"10","author":"Davis","year":"2022"},{"key":"b33","series-title":"Adolescents","first-page":"382","article-title":"Determinants of contraceptive use among unmarried young women in Kakamega County, Kenya","volume":"3","author":"Arlotti-Parish","year":"2023"},{"key":"b34","article-title":"Community Policing Information Booklet.","year":"2017"},{"key":"b35","article-title":"Improving Kenya\u2019s COVID-19 Outcomes the Nyumba Kumi Way.","author":"Omondi","year":"2020"},{"key":"b36","article-title":"National Education Sector Strategic Plan for the Period 2018\u20132022.","year":"2019"},{"key":"b37","series-title":"Malar J","first-page":"481","article-title":"Seasonal malaria chemoprevention: Successes and missed opportunities","volume":"16","author":"Coldiron","year":"2017"},{"key":"b38","series-title":"Pastoralism","first-page":"7","article-title":"A One Health framework for integrated service delivery in Turkana County, Kenya","volume":"10","author":"Griffith","year":"2020"},{"key":"b39","article-title":"Turkana County Launches Its First \u201cOne Health Strategy\u201d in Lodwar.","year":"2023"},{"key":"b40","first-page":"ohcs20230022","article-title":"One health in Turkana County, Kenya: Applications and lessons learned","volume":"2023","author":"Griffith","year":"2023"},{"key":"b41","series-title":"J Biosoc Sci","first-page":"819","article-title":"Understanding hard-to-reach communities: Local perspectives and experiences of trachoma control among the pastoralist Maasai in northern Tanzania","volume":"53","author":"Mtuy","year":"2021"},{"key":"b42","series-title":"Int Health","first-page":"10","article-title":"Nomadic Fulani communities manage malaria on the move","volume":"4","author":"Akogun","year":"2012"},{"key":"b43","series-title":"BMC Health Serv Res","first-page":"457","article-title":"Community engagement processes in low- and middle-income countries health research settings: A systematic review of the literature","volume":"23","author":"Mthembu","year":"2023"},{"key":"b1","article-title":"World Malaria Report 2022.","year":"2022"},{"key":"b2","article-title":"WHO Policy Recommendation: Seasonal Malaria Chemoprevention (SMC) for Plasmodium falciparum Malaria Control in Highly Seasonal Transmission Areas of the Sahel Sub-Region in Africa.","year":"2012"},{"key":"b3","article-title":"Global Technical Strategy for Malaria 2016\u20132030, 2021 Update.","year":"2021"},{"key":"b4","article-title":"Updated WHO Recommendations for Malaria Chemoprevention and Elimination.","year":"2022"},{"key":"b5","series-title":"Cochrane Database Syst Rev","first-page":"CD003756","article-title":"Chemoprophylaxis and intermittent treatment for preventing malaria in children","volume":"2","author":"Meremikwu","year":"2008"},{"key":"b6","series-title":"Am J Trop Med Hyg","first-page":"20","article-title":"Systematic review and meta-analysis of seasonal malaria chemoprevention","volume":"110","author":"Thwing","year":"2024"},{"key":"b7","series-title":"PLoS One","first-page":"e0193296","article-title":"Optimal mode for delivery of seasonal malaria chemoprevention in Ouelessebougou, Mali: A cluster randomized trial","volume":"13","author":"Barry","year":"2018"},{"key":"b8","series-title":"PLoS One","first-page":"e32900","article-title":"Intermittent preventive treatment of malaria in children: A qualitative study of community perceptions and recommendations in Burkina Faso and Mali","volume":"7","author":"Pitt","year":"2012"},{"key":"b9","series-title":"PLoS One","first-page":"e7256","article-title":"Options for the delivery of intermittent preventive treatment for malaria to children: A community randomised trial","volume":"4","author":"Kweku","year":"2009"},{"key":"b10","article-title":"WHO Consolidated Guidelines for Malaria.","year":"2023"},{"key":"b11","article-title":"The Epidemiology and Control Profile of Malaria in Kenya: Reviewing the Evidence to Guide the Future Vector Control.","author":"Noor","year":"2016"},{"key":"b12","series-title":"Am J Trop Med Hyg","first-page":"1076","article-title":"Epidemiology of Plasmodium falciparum infections in a semi-arid rural African setting: Evidence from reactive case detection in Northwestern Kenya","volume":"105","author":"Meredith","year":"2021"},{"key":"b13","series-title":"PLOS Glob Public Health","first-page":"e0000807","article-title":"Plasmodium falciparum importation does not sustain malaria transmission in a semi-arid region of Kenya","volume":"2","author":"Markwalter","year":"2022"},{"key":"b14","article-title":"Turkana County SMART Nutrition Surveys.","year":"2019"},{"key":"b15","series-title":"PLOS Glob Public Health","first-page":"e0002750","article-title":"Characterizing mobility patterns and malaria risk factors in semi-nomadic populations of Northern Kenya","volume":"4","author":"Meredith","year":"2024"},{"key":"b16","article-title":"Turkana County: County Integrated Development Plan, CIDP II 2018\u20132022.","year":"2018"},{"key":"b17","article-title":"Turkana County Kicks off Measles Vaccination Campaign \u2013 Kenya News Agency.","author":"Gitonga","year":"2023"},{"key":"b18","article-title":"Turkana Children to be Vaccinated against Polio.","author":"Etyang","year":"2019"},{"key":"b19","series-title":"Ethn Health","first-page":"817","article-title":"Planning and implementing a targeted polio vaccination campaign for Somali mobile populations in Northeastern Kenya based on migration and settlement patterns","volume":"27","author":"Harvey","year":"2022"},{"key":"b20","article-title":"New Malaria Prevention Strategy, \u2018SMC\u2019 Set to Reduce Malaria Related Deaths among Children in Turkana \u2013 Turkana County Government.","year":"2024"},{"key":"b21","series-title":"PLoS Negl Trop Dis","first-page":"e0008474","article-title":"Health services uptake among nomadic pastoralist populations in Africa: A systematic review of the literature","volume":"14","author":"Gammino","year":"2020"},{"key":"b22","series-title":"BMC Med","first-page":"172","article-title":"Leaving no one behind: Targeting mobile and migrant populations with health interventions for disease elimination\u2014A descriptive systematic review","volume":"20","author":"Adams","year":"2022"},{"key":"b23","series-title":"Front Trop Dis","first-page":"1007480","article-title":"Challenges and strategies for the uptake of mass drug administration among pastoralist communities in South Sudan","volume":"4","author":"Muchiri","year":"2023"},{"key":"b24","series-title":"Trop Med Int Health","first-page":"1332","article-title":"Health interventions among mobile pastoralists: A systematic review to guide health 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