1921
Volume 103 Number 2_Suppl
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Malaria burden in Zambia has significantly declined over the last decade because of improved coverage of several key malaria interventions (e.g., vector control, case management, bed net distributions, and enhanced surveillance/responses). Campaign-based mass drug administration (MDA) and focal MDA (fMDA) were assessed in a trial in Southern Province, Zambia, to identify its utility in elimination efforts. As part of the study, a longitudinal cohort was visited and tested (by PCR targeting the 18s rRNA and a –specific rapid diagnostic test [RDT] from SD Bioline) every month for the trial duration (18 months). Overall, there was high concordance (> 97%) between the PCR and RDT results, using the PCR as the gold standard. The RDTs had high specificity and negative predictive values (98.5% and 98.6%, respectively) but low sensitivity (53.0%) and a low positive predictive value (53.8%). There was evidence for persistent antigenemia affecting the low specificity of the RDT, while false-negative RDTs were associated with a lower parasite density than true positive RDTs. was the dominant species identified, with 98.3% of all positive samples containing . Of these, 97.5% were mono-infections and 0.8% coinfections with one other species. was found in 1.4% of all positive samples (50% mono-infections and 50% coinfections with ), whereas was found in 1.1% of all positive samples (90% mono-infections and 10% coinfections with ). Although MDA/fMDA appeared to reduce prevalence, prevalence appeared unchanged.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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  • Received : 06 Sep 2019
  • Accepted : 20 Feb 2020
  • Published online : 02 Jul 2020
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