A Controlled Trial of Mass Drug Administration to Interrupt Transmission of Multidrug-Resistant Falciparum Malaria in Cambodian Villages

Tripura, Rupam; Peto, Thomas J.; Nguon, Chea; Davoeung, Chan; Mukaka, Mavuto; Sirithiranont, Pasathorn; Dhorda, Mehul; Promnarate, Cholrawee; Imwong, Mallika; Seidlein, Lorenz von; Duanguppama, Jureeporn; Patumrat, Krittaya; Huy, Rekol; Grobusch, Martin P.; Day, Nicholas P. J.; White, Nicholas J.; Dondorp, Arjen M.

doi:10.1093/cid/ciy196

Cited by 52 publications

(54 citation statements)

References 29 publications

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“…[32] revealed that the spread of multi-drug resistant P. falciparum malaria in GMS countries was accelerating, highlighting the urgent need to adopt an effective strategy to eliminate malaria. Recently published studies [9,13,29,33] suggest that targeted/focal MDA with a high degree of community participation can rapidly reduce malaria infections to zero when used in conjunction with intensive vector control and standard case management. There was no signi cant increase in any of the genetic markers for resistance after MDA [29].…”

Section: Discussionmentioning

confidence: 99%

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An ingredients-based approach to costing integrated malaria elimination strategies: an example from Myanmar

Kyaw

Delmas

Drake³

et al. 2020

Preprint

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Background Mass drug administration (MDA) has received growing interest to accelerate the elimination of multi-drug resistant malaria in the Greater Mekong Subregion. 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 is to be included in elimination packages beyond existing malaria interventions. Methods We used financial data from a malaria elimination initiative, conducted in Kayin State, to estimate the programmatic costs of the MDA component using a micro-costing approach. Three activities (community engagement, identification of villages for MDA, and conducting mass treatment in target villages) were evaluated. We then estimate the programmatic costs of implementing targeted MDA to support P. falciparum malaria elimination in Kayin State. A costing tool was developed to aid future analyses.Results The cost of delivering MDA within an integrated malaria elimination initiative in Eastern Kayin State was approximately US$ 910 000. The cost per person reached for MDA was US$ 2·5. Conclusion This cost analysis can assist policy makers in determining the resources required to clear malaria parasite reservoirs. The analysis demonstrated the value of using financial data from research activities to predict programmatic implementation costs of MDA in different numbers of target villages.

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Section: Discussionmentioning

confidence: 99%

“…A series of targeted MDA projects have recently been piloted in countries in the GMS [7][8][9][10] and Africa [11,12]. These trials have demonstrated that MDA is feasible and well-accepted by communities, with high levels of community participation.…”

mentioning

confidence: 99%

An ingredients-based approach to costing integrated malaria elimination strategies: an example from Myanmar

Kyaw

Delmas

Drake³

et al. 2020

Preprint

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“…Two sources for new infections in MDA treated communities are, (a) residual infections in the community due to incomplete coverage and exclusion from MDA and, (b) the reimportation of infections by visitors and returning residents. In Cambodia, the TME trial tried to address this challenge by presumptively treating permanent visitors and returning residents with a single round of threedose DHA/piperaquine [59]. Alternative approaches include the inclusion of the available, imperfect malaria vaccines [60].…”

Section: Box 4: How Effective Remains Dha/piperaquine For Mda In the mentioning

confidence: 99%

Tools to accelerate falciparum malaria elimination in Cambodia: a meeting report

Lek

Callery

Nguon

et al. 2020

Malar J

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Cambodia targets malaria elimination by 2025. Rapid elimination will depend on successfully identifying and clearing malaria foci linked to forests. Expanding and maintaining universal access to early diagnosis and effective treatment remains the key to malaria control and ultimately malaria elimination in the Greater Mekong Subregion (GMS) in the foreseeable future. Mass Drug Administration (MDA) holds some promise in the rapid reduction of Plasmodium falciparum infections, but requires considerable investment of resources and time to mobilize the target communities. Furthermore, the most practical drug regimen for MDA in the GMS-three rounds of DHA/piperaquine-has lost some of its efficacy. Mass screening and treatment benefits asymptomatic P. falciparum carriers by clearing chronic infections, but in its current form holds little promise for malaria elimination. Hopes that "highly sensitive" diagnostic tests would provide substantial advances in screen and treat programmes have been shown to be misplaced. To reduce the burden on P. falciparum and Plasmodium vivax infections in people working in forested areas novel approaches to the use of malaria prophylaxis in forest workers should be explored. During an October 2019 workshop in Phnom Penh researchers and policymakers reviewed evidence of acceptability, feasibility and effectiveness of interventions to target malaria foci and interrupt P. falciparum transmission and discussed operational requirements and conditions for programmatic implementation.

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“…The study was conducted in rural Eastern Kayin (Karen) State of Myanmar; in two provinces of Vietnam (Binh Phuoc and Ninh Thuan provinces: the former is in the Southeast region of the country and shares a border with Cambodia, while the latter embraces the South Central Coast of Vietnam); in Samlout District of Battambang province, Western Cambodia which shares a border with Thailand), and in Nong Districts of Savannakhet province, southern Lao PDR which shares a border with Vietnam. The location of the study sites is shown in Fig 1. Detailed descriptions of the study sites have been published recently [6][7][8][9].…”

Section: Study Sitementioning

confidence: 99%

Mass drug administrations with dihydroartemisinin-piperaquine and single low dose primaquine to eliminate Plasmodium falciparum have only a transient impact on Plasmodium vivax: Findings from randomised controlled trials

et al. 2020

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A Controlled Trial of Mass Drug Administration to Interrupt Transmission of Multidrug-Resistant Falciparum Malaria in Cambodian Villages

Abstract: In Cambodian villages, 3-month mass drug administration with high coverage using dihydroartemisinin-piperaquine was safe and was followed by the absence of clinical Plasmodium falciparum cases for at least 1 year, despite the presence of multidrug-resistant parasites.

Cited by 52 publications

References 29 publications

An ingredients-based approach to costing integrated malaria elimination strategies: an example from Myanmar

An ingredients-based approach to costing integrated malaria elimination strategies: an example from Myanmar

Tools to accelerate falciparum malaria elimination in Cambodia: a meeting report

Mass drug administrations with dihydroartemisinin-piperaquine and single low dose primaquine to eliminate Plasmodium falciparum have only a transient impact on Plasmodium vivax: Findings from randomised controlled trials

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