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NOT Open Access | Broadening the range of use cases for ivermectin - a review of the evidence

August 4, 2021 - 11:58 -- NOT Open Access
Kositz C, Bradley J, Hutchins H, Last A, D'Alessandro U, Marks M
Trans R Soc Trop Med Hyg. 2021 Jul 29:trab114

Ivermectin is a broad-spectrum antiparasitic agent that interferes with glutamate-gated chloride channels found in invertebrates but not in vertebrate species. Mass drug administration (MDA) with ivermectin-based regimes has been a mainstay of elimination efforts targeting onchocerciasis and lymphatic filariasis for more than 3 decades. More recently, interest in the use of ivermectin to control other neglected tropical diseases (NTDs) such as soil-transmitted helminths and scabies has grown.

NOT Open Access | Design and analysis of a 2-year parallel follow-up of repeated ivermectin mass drug administrations for control of malaria: Small sample considerations for cluster-randomized trials with count data

July 6, 2021 - 13:45 -- NOT Open Access
Jackson CL, Colborn K, Gao D, Rao S, Slater HC, Parikh S, Foy BD, Kittelson J
Clin Trials. 2021 Jul 3:17407745211028581

Cluster-randomized trials allow for the evaluation of a community-level or group-/cluster-level intervention. For studies that require a cluster-randomized trial design to evaluate cluster-level interventions aimed at controlling vector-borne diseases, it may be difficult to assess a large number of clusters while performing the additional work needed to monitor participants, vectors, and environmental factors associated with the disease. One such example of a cluster-randomized trial with few clusters was the “efficacy and risk of harms of repeated ivermectin mass drug administrations for control of malaria” trial. Although previous work has provided recommendations for analyzing trials like repeated ivermectin mass drug administrations for control of malaria, additional evaluation of the multiple approaches for analysis is needed for study designs with count outcomes.

Mass drug administration for the acceleration of malaria elimination in a region of Myanmar with artemisinin-resistant falciparum malaria: a cluster-randomised trial

June 22, 2021 - 15:07 -- Open Access
McLean ARD, Indrasuta C, Smithuis FM, et al.
Lancet Infect Dis. 2021 Jun 17:S1473-3099(20)30997-X

To contain multidrug-resistant Plasmodium falciparum, malaria elimination in the Greater Mekong subregion needs to be accelerated while current antimalarials remain effective. We evaluated the safety, effectiveness, and potential resistance selection of dihydroartemisinin–piperaquine mass drug administration (MDA) in a region with artemisinin resistance in Myanmar.

Not Open Access | The short-term impact of a malaria elimination initiative in Southern Mozambique: Application of the synthetic control method to routine surveillance data

June 15, 2021 - 14:40 -- NOT Open Access
Thomas R, Cirera L, Brew J, Saúte F, Sicuri E
Health Econ. 2021 Jun 8

In public health epidemiology, quasi-experimental methods are widely used to estimate the causal impacts of interventions. In this paper, we demonstrate the contribution the synthetic control method (SCM) can make in evaluating public health interventions, when routine surveillance data are available and the validity of other quasi-experimental approaches may be in question.

Why Did Mass Test and Treat Have No Effect on Malaria Prevalence in Western Kenya

June 5, 2021 - 07:21 -- Open Access
Hamer DH, Miller JM
Clin Infect Dis. 2021 Jun 1;72(11):1936-1937

Great progress has been made in malaria control during the last 2 decades, although recent estimates suggest that this process has stagnated. Building on the optimism generated by the reductions in malaria-associated morbidity and mortality, there has been a growth in enthusiasm for malaria elimination with the eventual goal of eradication.

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.


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