AI Article Synopsis
- Mass drug administration (MDA) with dihydroartemisinin-piperaquine (DP) was tested in a study to evaluate its effect on reducing malaria transmission in low-transmission areas.
- The study found that there was a significant drop in malaria infection rates and clinical cases in 2014 and 2015 compared to 2013, with a coverage rate of over 65% for the drug.
- However, individuals previously infected had a higher risk of reinfection post-MDA, and while the intervention was effective in many areas, it was less successful in eastern Gambia, suggesting that targeted and repeated MDA could enhance malaria control.
Article Abstract
Background: Mass drug administration (MDA) may further reduce malaria transmission in low-transmission areas. The impact of MDA on the dynamics of malaria transmission was determined in a prospective cohort study.
Methods: Annual rounds of MDA with dihydroartemisinin-piperaquine (DP) were implemented were implemented in 2014 and 2015 in six village pairs before the malaria transmission season. Blood samples were collected from residents between July and December for microscopy and nested PCR. Incidence and prevalence of infection, clinical disease, and risk of malaria reinfection post-MDA were determined.
Results: Coverage of three DP doses was 68.2% (2014) and 65.6% (2015), compliance was greater than 80%. Incidence of infection was significantly lower in 2014 (incidence rate [IR] = 0.2 per person year [PPY]) than in 2013 (IR = 1.1 PPY; P < .01); monthly infection prevalence declined in the first three months post-MDA. Clinical malaria incidence was lower in 2014 (IR = 0.1 PPY) and 2015 (IR = 0.2 PPY) than in 2013 (IR = 0.4 PPY; P < .01), but remained higher in eastern Gambia. Individuals infected before MDA had a 2-fold higher odds of reinfection post-MDA (adjusted odds ratio = 2.5, 95% confidence interval 1.5-4.3; P < .01).
Conclusions: MDA reduced malaria infection and clinical disease during the first months. The reduction was maintained in low-transmission areas, but not in eastern Gambia. Annual MDA could be followed by focal MDA targeting individuals infected during the dry season. Repeated MDA rounds, some during the dry season over larger geographical areas, may result in a more marked and sustained decrease of malaria transmission.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6603267 | PMC |
| http://dx.doi.org/10.1093/cid/ciy870 | DOI Listing |
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