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mass drug administration

Costing malaria interventions from pilots to elimination programmes

September 15, 2020 - 10:34 -- Open Access
Author(s): 
Katya Galactionova, Mar Velarde, Kafula Silumbe, John Miller, Anthony McDonnell, Ricardo Aguas, Thomas A. Smith and Melissa A. Penny
Reference: 
Malaria Journal 2020 19:332, 14 September 2020

Malaria programmes in countries with low transmission levels require evidence to optimize deployment of current and new tools to reach elimination with limited resources. Recent pilots of elimination strategies in Ethiopia, Senegal, and Zambia produced evidence of their epidemiological impacts and costs. There is a need to generalize these findings to different epidemiological and health systems contexts.

Evaluating the impact of programmatic mass drug administration for malaria in Zambia using routine incidence data

July 21, 2020 - 15:47 -- Open Access
Author(s): 
Fraser M, Miller JM, Guinovart C, et al.
Reference: 
J Infect Dis. 2020 Jul 21:jiaa434

In 2016, the Zambian National Malaria Elimination Centre started programmatic mass drug administration (pMDA) campaigns with dihydroartemisinin-piperaquine as a malaria elimination tool in Southern Province. Two rounds were administered, two months apart (coverage 70% and 57% respectively). We evaluated the impact of one year of pMDA on malaria incidence using routine data.

Moving towards malaria elimination in southern Mozambique: Cost and cost-effectiveness of mass drug administration combined with intensified malaria control

July 7, 2020 - 13:41 -- Open Access
Author(s): 
Cirera L, Galatas B, Alonso S, Paaijmans K, Mamuquele M, Martí-Soler H, Guinovart C, Munguambe H, Luis F, Nhantumbo H, Montañà J, Bassat Q, Candrinho B, Rabinovich R, Macete E, Aide P, Alonso P, Saúte F, Sicuri E
Reference: 
PLoS ONE 15(7): e0235631

As new combinations of interventions aiming at interrupting malaria transmission are under evaluation, understanding the associated economic costs and benefits is critical for decision-making. This study assessed the economic cost and cost-effectiveness of the Magude project, a malaria elimination initiative implemented in a district in southern Mozambique (i.e. Magude) between August 2015–June 2018. This project piloted a combination of two mass drug administration (MDA) rounds per year for two consecutive years, annual rounds of universal indoor residual spraying (IRS) and a strengthened surveillance and response system on the back of universal long-lasting insecticide treated net (LLIN) coverage and routine case management implemented by the National Malaria Control Program (NMCP). Although local transmission was not interrupted, the project achieved large reductions in the burden of malaria in the target district.

Adherence to Mass Drug Administration with Dihydroartemisinin-Piperaquine and Plasmodium falciparum Clearance in Southern Province, Zambia

July 7, 2020 - 13:05 -- Open Access
Author(s): 
Finn TP, Porter TR, Moonga H, Silumbe K, Daniels RF, Volkman SK, Yukich JO, Keating J, Bennett A, Steketee RW, Miller JM, Eisele TP
Reference: 
Am. J. Trop. Med. Hyg., 00(0), 2020, pp. 1–9

Mass drug administration (MDA) with artemisinin combination therapy is a potentially useful tool for malaria elimination programs, but its success depends partly on drug effectiveness and treatment coverage in the targeted population. As part of a cluster-randomized controlled trial in Southern Province, Zambia evaluating the impact of MDA and household focal MDA (fMDA) with dihydroartemisinin-piperaquine (DHAp), sub-studies were conducted investigating population drug adherence rates and effectiveness of DHAp as administered in clearing Plasmodium falciparum infections following household mass administration.

Moving from Malaria Burden Reduction toward Elimination: An Evaluation of Mass Drug Administration in Southern Province, Zambia

July 7, 2020 - 13:00 -- Open Access
Author(s): 
Miller JM, Eisele TP, Fraser MS, Lewis MT, Slutsker L, Chizema Kawesha E
Reference: 
Am. J. Trop. Med. Hyg., 00(0), 2020, pp. 1–4

From December 2014 to February 2016, a cluster randomized controlled trial was carried out in 60 health facility catchment areas along Lake Kariba in Zambia's Southern Province. The trial sought to evaluate the impact of four rounds of a mass drug administration (MDA) intervention with dihydroartemisinin-piperaquine (DHAP) or focal MDA with DHAP at the household level compared with a control population that received the standard of care.

The Role of Mass Drug Administration of Antimalarials

July 7, 2020 - 12:51 -- Open Access
Author(s): 
Alonso PL
Reference: 
Am. J. Trop. Med. Hyg., 00(00), 2020, pp. 1–2

Either intuition or empiricism must have led to the use of antimalarial drugs to both treat and prevent malaria, pre-dating the identification of the malaria parasite and the mode of its transmission. Josep Masdevall in the XVIII century managed epidemics in Spain through the administration of compounds that included the bark of the cinchona tree. In more recent times, mass drug administration (MDA) was the first form of chemoprevention used against malaria in the early 1900s.

Prevalence of Plasmodium falciparum and Non-falciparum Infections by Photo-Induced Electron Transfer-PCR in a Longitudinal Cohort of Individuals Enrolled in a Mass Drug Administration Trial in Southern Province, Zambia

July 7, 2020 - 12:46 -- Open Access
Author(s): 
Chishimba S, Mwenda M, Mambwe B, Mulube C, Chalwe V, Moonga H, Hamainza B, Chizema-Kawesha E, Steketee RW, Domingo G, Fraser M, Kahn M, Pal S, Silumbe K, Conner RO, Bennett A, Porter TR, Eisele TP, Miller JM, Bridges DJ
Reference: 
Am. J. Trop. Med. Hyg., 00(0), 2020, pp. 1–8

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.

Treatment Coverage Estimation for Mass Drug Administration for Malaria with Dihydroartemisinin-Piperaquine in Southern Province, Zambia

July 7, 2020 - 12:43 -- Open Access
Author(s): 
Finn TP, Yukich JO, Bennett A, Porter TR, Lungu C, Hamainza B, Chizema Kawesha E, Conner RO, Silumbe K, Steketee RW, Miller JM, Keating J, Eisele TP
Reference: 
Am J Trop Med Hyg. 2020 Jul 2

Mass drug administration (MDA) is currently being considered as an intervention in low-transmission areas to complement existing malaria control and elimination efforts. The effectiveness of any MDA strategy is dependent on achieving high epidemiologic coverage and participant adherence rates. A community-randomized controlled trial was conducted from November 2014 to March 2016 to evaluate the impact of four rounds of MDA or focal MDA (fMDA)-where treatment was given to all eligible household members if anyone in the household had a positive malaria rapid diagnostic test-on malaria outcomes in Southern Province, Zambia (population approximately 300,000).

Cost-Effectiveness of Focal Mass Drug Administration and Mass Drug Administration with Dihydroartemisinin-Piperaquine for Malaria Prevention in Southern Province, Zambia: Results of a Community-Randomized Controlled Trial

July 7, 2020 - 12:40 -- Open Access
Author(s): 
Yukich JO, Scott C, Silumbe K, Larson BA, Bennett A, Finn TP, Hamainza B, Conner RO, Porter TR, Keating J, Steketee RW, Eisele TP, Miller JM
Reference: 
Am. J. Trop. Med. Hyg., 00(0), 2020, pp. 1–8

Community-wide administration of antimalarial drugs in therapeutic doses is a potential tool to prevent malaria infection and reduce the malaria parasite reservoir. To measure the effectiveness and cost of using the antimalarial drug combination dihydroartemisinin-piperaquine (DHAp) through different community-wide distribution strategies, Zambia's National Malaria Control Centre conducted a three-armed community-randomized controlled trial.

Impact of Four Rounds of Mass Drug Administration with Dihydroartemisinin-Piperaquine Implemented in Southern Province, Zambia

July 6, 2020 - 17:08 -- Open Access
Author(s): 
Eisele TP, Bennett A, Miller JM, et al.
Reference: 
Am J Trop Med Hyg. 2020 Jul 2

Over the past decade, Zambia has made substantial progress against malaria and has recently set the ambitious goal of eliminating by 2021. In the context of very high vector control and improved access to malaria diagnosis and treatment in Southern Province, we implemented a community-randomized controlled trial to assess the impact of four rounds of community-wide mass drug administration (MDA) and household-level MDA (focal MDA) with dihydroartemisinin-piperaquine (DHAP) implemented between December 2014 and February 2016.

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