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Estimating the programmatic cost of targeted mass drug administration for malaria in Myanmar

May 5, 2021 - 08:36 -- Open Access
Kyaw SS, Delmas G, Nosten F, et al.
BMC Public Health. 2021 Apr 29;21(1):826

Mass drug administration (MDA) has received growing interest to accelerate the elimination of multi-drug resistant malaria in the Greater Mekong Subregion. Targeted MDA, sometimes referred to as focal MDA, is the practice of delivering MDA to high incidence subpopulations only, rather than the entire population. The potential effectiveness of delivering targeted MDA was demonstrated in a recent intervention in Kayin State, Myanmar. Policymakers and funders need to know what resources are required if MDA, targeted or otherwise, is to be included in elimination packages beyond existing malaria interventions. This study aims to estimate the programmatic cost and the unit cost of targeted MDA in Kayin State, Myanmar.

From informed consent to adherence: factors influencing involvement in mass drug administration with ivermectin for malaria elimination in The Gambia

April 28, 2021 - 15:47 -- Open Access
Alexandra Fehr, Claudia Nieto-Sanchez, Koen Peeters Grietens, et al.
Malaria Journal 2021 20:198, 26 April 2021

The World Health Organization (WHO) recommends consideration of mass drug administration (MDA) for malaria control in low-endemic settings approaching elimination. However, MDA remains a controversial strategy, as multiple individual, social, and operational factors have shown to affect its acceptability at local levels. This is further complicated by inconsistent definitions of key indicators derived from individual and community involvement—coverage, adherence, and compliance—that cast doubts about the actual and potential epidemiological impact of MDA on disease control and elimination. This study aimed to identify limitations and enabling factors impacting involvement at different stages of a large cluster-randomized trial assessing the effect of combining dihydroartemisinin-piperaquine (DP) and ivermectin (IVM) in malaria transmission in The Gambia.

A systematic review of factors influencing participation in two types of malaria prevention intervention in Southeast Asia

April 21, 2021 - 15:14 -- Open Access
Breagh Cheng, Saw Nay Htoo, Naw Pue Pue Mhote and Colleen M. Davison
Malaria Journal 2021 20:195, 20 April 2021

Multi-pronged malaria elimination strategies are increasingly being considered for accelerating efforts against malaria transmission in Southeast Asia. Two malaria prevention interventions used in in the region are insecticide-treated bed-nets (ITNs) and mass drug administration (MDA). Universal access to ITNs is recommended and high population coverage (e.g. above 80%) is needed during MDA initiatives to maximize the impact of these interventions. However, variability in ITN use and individual MDA participation exists. This systematic review aims to provide a summary and overview of literature discussing factors influencing uptake of these two malaria control strategies in Southeast Asian countries.

The assembly effect: the connectedness between populations is a double‐edged sword for public health interventions

April 21, 2021 - 14:42 -- Open Access
Sai Thein Than Tun, Daniel M. Parker, Ricardo Aguas and Lisa J. White
Malaria Journal 2021 20:189, 17 April 2021

Many public health interventions lead to disruption or decrease of transmission, providing a beneficial effect for people in the population regardless of whether or not they individually participate in the intervention. This protective benefit has been referred to as a herd or community effect and is dependent on sufficient population participation. In practice, public health interventions are implemented at different spatial scales (i.e., at the village, district, or provincial level). Populations, however defined (i.e., neighbourhoods, villages, districts) are frequently connected to other populations through human movement or travel, and this connectedness can influence potential herd effects.

Community acceptability to antimalarial mass drug administrations in Magude district, Southern Mozambique: A mixed methods study

March 24, 2021 - 14:03 -- Open Access
Galatas B, Nhantumbo H, Munguambe K, et al.
PLoS One. 2021 Mar 23;16(3):e0249080

This study aimed to capture the acceptability prior to, during and after the implementation of the first year of MDA rounds conducted under the Magude project, a malaria elimination project in southern Mozambique.

Rapid ethnographic assessment for potential anti-malarial mass drug administration in an outbreak area of Santo Domingo, Dominican Republic

February 10, 2021 - 09:54 -- Open Access
Hunter Keys, Keyla Ureña, Jhefres Reyes, Kevin Bardosh, Christopher Pell, Jose Puello, Stephen Blount and Gregory S. Noland
Malaria Journal 2021 20:76, 8 February 2021

In the Dominican Republic, a recent outbreak of malaria in the capital, Santo Domingo, threatens efforts to eliminate the disease. Mass drug administration (MDA) has been proposed as one strategy to reduce transmission. The success of MDA is contingent upon high levels of acceptance among the target population. To inform the design of future MDA campaigns, this rapid ethnographic assessment examined malaria-related knowledge and attitudes toward malaria MDA among residents of a transmission focus in Santo Domingo.

Estimating malaria chemoprevention and vector control coverage using program and campaign data: A scoping review of current practices and opportunities

December 2, 2020 - 08:41 -- Open Access
Nice J, Nahusenay H, Eckert E, Eisele TP, Ashton RA
J Glob Health. 2020 Dec;10(2):020413

Accurate estimation of intervention coverage is a vital component of malaria program monitoring and evaluation, both for process evaluation (how well program targets are achieved), and impact evaluation (whether intervention coverage had an impact on malaria burden). There is growing interest in maximizing the utility of program data to generate interim estimates of intervention coverage in the periods between large-scale cross-sectional surveys (the gold standard). As such, this study aimed to identify relevant concepts and themes that may guide future optimization of intervention coverage estimation using routinely collected data, or data collected during and following intervention campaigns, with a particular focus on strategies to define the denominator.

Mass Drug Administration With High-Dose Ivermectin and Dihydroartemisinin-Piperaquine for Malaria Elimination in an Area of Low Transmission With High Coverage of Malaria Control Interventions: Protocol for the MASSIV Cluster Randomized Clinical Trial

November 25, 2020 - 12:10 -- Open Access
Dabira ED, Soumare HM, D'Alessandro U, et al.
JMIR Res Protoc. 2020 Nov 19;9(11):e20904

With a decline in malaria burden, innovative interventions and tools are required to reduce malaria transmission further. Mass drug administration (MDA) of artemisinin-based combination therapy (ACT) has been identified as a potential tool to further reduce malaria transmission, where coverage of vector control interventions is already high. However, the impact is limited in time. Combining an ACT with an endectocide treatment that is able to reduce vector survival, such as ivermectin (IVM), could increase the impact of MDA and offer a new tool to reduce malaria transmission.

Sero-epidemiological evaluation of malaria transmission in The Gambia before and after mass drug administration

November 17, 2020 - 13:11 -- Open Access
Wu L, Mwesigwa J, Affara M, Drakeley C, et al.
BMC Med. 2020 Nov 13;18(1):331

As The Gambia aims to achieve malaria elimination by 2030, serological assays are a useful surveillance tool to monitor trends in malaria incidence and evaluate community-based interventions.

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
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
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.

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