World Health Organization , 2021. World Malaria Report 2021. Available at: https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2021. Accessed February 8, 2022.
Kamya MR et al.2015. Malaria transmission, infection, and disease at three sites with varied transmission intensity in Uganda: implications for malaria control. Am J Trop Med Hyg 92: 903–912.
Nankabirwa JI , Arinaitwe E , Rek J , Kilama M , Kizza T , Staedke SG , Rosenthal PJ , Rodriguez-Barraquer I , Briggs J , Greenhouse B , Bousema T , Drakeley C , Roos DS , Tomko SS , Smith DL , Kamya MR , Dorsey G , 2020. Malaria Transmission, Infection, and Disease following Sustained Indoor Residual Spraying of Insecticide in Tororo, Uganda. Am J Trop Med Hyg 103: 1525–1533.
Andolina C , Rek JC , Briggs J , Okoth J , Musiime A , Ramjith J , Teyssier N , Conrad M , Nankabirwa JI , Lanke K , Rodriguez-Barraquer I , Meerstein-Kessel L , Arinaitwe E , Olwoch P , Rosenthal PJ , Kamya MR , Dorsey G , Greenhouse B , Drakeley C , Staedke SG , Bousema T , 2021. Sources of persistent malaria transmission in a setting with effective malaria control in eastern Uganda: a longitudinal, observational cohort study. Lancet Infect Dis 21: 1568–1578.
Pinotti M , 1954. New method of malaria prevention: combination of an antimalarial drug with table salt used daily in food. Rev Bras Malariol Doencas Trop 6: 5–12.
von Seidlein L , Greenwood BM , 2003. Mass administrations of antimalarial drugs. Trends Parasitol 19: 452–460.
Newby G et al.2015. Review of mass drug administration for malaria and its operational challenges. Am J Trop Med Hyg 93: 125–134.
von Seidlein L , Dondorp A , 2015. Fighting fire with fire: mass antimalarial drug administrations in an era of antimalarial resistance. Expert Rev Anti Infect Ther 13: 715–730.
Feachem RG et al.2010. Shrinking the malaria map: progress and prospects. Lancet 376: 1566–1578.
Eisele TP et al.2016. Short-term impact of mass drug administration with dihydroartemisinin plus piperaquine on malaria in Southern Province Zambia: a cluster-randomized controlled trial. J Infect Dis 214: 1831–1839.
Eisele TP et al.2020. Impact of four rounds of mass drug administration with dihydroartemisinin–piperaquine implemented in Southern Province, Zambia. Am J Trop Med Hyg 103: 7–18.
Gao B , Saralamba S , Lubell Y , White LJ , Dondorp AM , Aguas R , 2020. Determinants of MDA impact and designing MDAs towards malaria elimination. Elife 9: e51773.
Brady OJ et al.2017. Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study. Lancet Glob Health 5: e680–e687.
World Health Organization , 2015. Global Technical Strategy for Malaria 2016–2030. Available at: https://apps.who.int/iris/bitstream/handle/10665/176712/9789241564991_eng.pdf?sequence=1. Accessed April 15, 2021.
Sanders K , Gueye CS , Phillips AA , Gosling R , 2012. Active case detection for malaria elimination: a confusion of acronyms and definitions. Malar Chemother Control Elimin 1: doi:10.4303/mcce/235552.
Griffin JT , Hollingsworth TD , Okell LC , Churcher TS , White M , Hinsley W , Bousema T , Drakeley CJ , Ferguson NM , Basáñez MG , Ghani AC , 2010. Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies. PLoS Med 7 (8):e1000324.
Tiono AB , Guelbeogo MW , Sagnon NF , Nébié I , Sirima SB , Mukhopadhyay A , Hamed K , 2013. Dynamics of malaria transmission and susceptibility to clinical malaria episodes following treatment of Plasmodium falciparum asymptomatic carriers: results of a cluster-randomized study of community-wide screening and treatment, and a parallel entomology study. BMC Infect Dis 13: 535.
Cook J et al.2015. Mass screening and treatment on the basis of results of a Plasmodium falciparum-specific rapid diagnostic test did not reduce malaria incidence in Zanzibar. J Infect Dis 211: 1476–1483.
Mwesigwa J et al.2019. Mass drug administration with dihydroartemisinin–piperaquine and malaria transmission dynamics in the Gambia: a prospective cohort study. Clin Infect Dis 69: 278–286.
Chaves LF , Huber JH , Rojas Salas O , Ramírez Rojas M , Romero LM , Gutiérrez Alvarado JM , Perkins TA , Prado M , Rodríguez RM , 2020. Malaria elimination in Costa Rica: changes in treatment and mass drug administration. Microorganisms 8 (7):984.
Nankabirwa JI et al.2020. Malaria transmission, infection, and disease following sustained indoor residual spraying of insecticide in Tororo, Uganda. Am J Trop Med Hyg 103: 1525–1533.
Hofmann N , Mwingira F , Shekalaghe S , Robinson LJ , Mueller I , Felger I , 2015. Ultra-sensitive detection of Plasmodium falciparum by amplification of multi-copy subtelomeric targets. PLoS Med 12: e1001788.
Gosling RD , Okell L , Mosha J , Chandramohan D , 2011. The role of antimalarial treatment in the elimination of malaria. Clin Microbiol Infect 17: 1617–1623.
Okell LC , Griffin JT , Kleinschmidt I , Hollingsworth TD , Churcher TS , White MJ , Bousema T , Drakeley CJ , Ghani AC , 2011. The potential contribution of mass treatment to the control of Plasmodium falciparum malaria. PLoS One 6: e20179.
World Health Organization , 2012. WHO Policy Recommendation: Seasonal Malaria Chemoprevention (SMC) for Plasmodium falciparum Malaria Control in Highly Seasonal Transmission Areas of the Sahel Sub-region in Africa. Available at: https://www.who.int/malaria/publications/atoz/who_smc_policy_recommendation/en/. Accessed July 8, 2020.
Steketee RW , Miller JM , Chizema Kawesha E , 2020. Implications of the MDA trial in Southern Province, Zambia, for malaria control and elimination. Am J Trop Med Hyg 103: 98–101.
Poirot E , Skarbinski J , Sinclair D , Kachur SP , Slutsker L , Hwang J , 2013. Mass drug administration for malarrane. Database Syst Rev (12):Cd008846. https://pubmed.ncbi.nlm.nih.gov/24318836/
Shah MP , Hwang J , Choi L , Lindblade KA , Kachur SP , Desai M , 2021. Mass drug administration for malaria. Cochrane Database Syst Rev 9: CD008846.
Talisuna AO , Noor AM , Okui AP , Snow RW , 2015. The past, present and future use of epidemiological intelligence to plan malaria vector control and parasite prevention in Uganda. Malar J 14: 158.
Mutabingwa TK , Watkins WM , d’Alessandro U , 2002. Monitoring of drug-resistant malaria in Africa. Lancet 360: 875.
Nankabirwa JI et al.2016. Intermittent preventive treatment with dihydroartemisinin–piperaquine in Ugandan schoolchildren selects for Plasmodium falciparum transporter polymorphisms that modify drug sensitivity. Antimicrob Agents Chemother 60: 5649–5654.
Andolina C et al.2021. Sources of persistent malaria transmission in a setting with effective malaria control in eastern Uganda: a longitudinal, observational cohort study. Lancet Infect Dis 21: 1568–1578.
Bretscher MT , Griffin JT , Ghani AC , Okell LC , 2017. Modelling the benefits of long-acting or transmission-blocking drugs for reducing Plasmodium falciparum transmission by case management or by mass treatment. Malar J 16: 341.
Eisele TP , 2019. Mass drug administration can be a valuable addition to the malaria elimination toolbox. Malar J 18: 281.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 3470 | 3470 | 31 |
Full Text Views | 51 | 51 | 0 |
PDF Downloads | 33 | 33 | 0 |
Highly effective vector control can reduce malaria burden significantly, but individuals with parasitemia provide a potential reservoir for onward transmission. We performed an empirical, non-parametric simulation based on cohort data from Tororo District, Uganda—an area with historically high but recently reduced malaria transmission—to estimate the effects of mass drug administration (MDA) and test-and-treat on parasite prevalence. We estimate that a single round of MDA would have accelerated declines in parasite prevalence dramatically over 2 years (cumulative parasite prevalence ratio [PPR], 0.34). This decline was mostly during the first year of administration (PPR, 0.23) and waned by 23 months (PPR, 0.74). Test-and-treat using a highly sensitive diagnostic had nearly the same effect as MDA at 1 year (PPR, 0.27) and required many fewer treatments. The impact of test-and-treat using a standard diagnostic was modest (PPR, 0.58 at 1 year). Our analysis suggests that in areas experiencing a dramatic reduction in malaria prevalence, MDA or test-and-treat with a highly sensitive diagnostic may be an effective way of reducing or eliminating the infectious reservoir temporarily. However, for sustained benefits, repeated rounds of the intervention or additional interventions are required.
Financial support: The primary study was funded by the NIH as part of the International Centers of Excellence in Malaria Research program (grant no. U19AI089674). J. I. N. is supported by the Fogarty International Center (Emerging Global Leader Award, grant no. K43TW010365). E. A. is supported by the Fogarty International Center of the NIH (award no. D43TW010526).
Disclaimer: The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Authors’ addresses: Joaniter I. Nankabirwa and Moses R. Kamya, Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda, and Infectious Disease Research Collaboration, Kampala, Uganda, E-mails: jnankabirwa@yahoo.co.uk and mkamya@infocom.co.ug. Emmanuel Arinaitwe, John Rek, and Peter Olwoch, Infectious Disease Research Collaboration, Kampala, Uganda, E-mails: earinaitwe@idrc-uganda.org, jrek@idrc-uganda.org, and polwoch@idrc-uganda.org. Jessica Briggs, Philip J. Rosenthal, Isabel Rodriguez-Barraquer, Grant Dorsey, and Bryan Greenhouse, Department of Infectious Diseases, School of Medicine, University of California, San Francisco, CA, E-mails: jessica.briggs@ucsf.edu, philip.rosenthal@ucsf.edu, isabel.rodriguez@ucsf.edu, grant.dorsey@ucsf.edu, and bryan.greenhouse@ucsf.edu. David L. Smith, Department of Health Metrics Sciences, University of Washington, Seattle, WA, smitdave@gmail.com.