Mass screening and treatment (MSaT) for identifying and treating asymptomatic cases of malaria-malaria elimination demonstration project (MEDP), Mandla, Madhya Pradesh

Abstract

Background Mass screening and treatment (MSaT) aims at reducing the spread of malaria in communities by identifying and treating infected persons regardless of the symptoms. This study was conducted to identify and treat asymptomatic cases using MSaT approaches in the community. Methods Three rounds of MSaT using cluster combination approaches were carried out during September 2018 to December 2019 to identify and treat asymptomatic malaria cases in the community. All individuals who were present in the household were screened using RDT irrespective of malaria related symptoms. Simultaneously thick and thin blood smear and blood spot were collected for further analysis using microscopy and diagnostic PCR done in a subset of the samples. Results Logistic regression analysis revealed that asymptomatic malaria cases significantly less among the older age groups compared with < 5 years children (OR ranged between 0.52 and 0.61; p < 0.05), lowest in cluster 4 (OR = 0.01; p < 0.0001); during third round of MSaT survey (OR = 0.11; p < 0.0001) and significantly higher in moderate to high endemic areas (OR = 88.30; p < 0.0001). Conclusion Over the three rounds of MSaT, the number of asymptomatic cases were significantly less in the older age groups, and during third round. Similarly, the asymptomatic cases were significantly less in the low endemic area with API < 1 (cluster four). Therefore, the malaria elimination programme may consider the MSaT strategy to identify asymptomatic cases that would be otherwise missed by routine fever based surveillance. This MSaT strategy would help accomplish the malaria elimination goal in an expedited manner.

Malaria elimination: situation analysis of cases in India, the state of Madhya Pradesh in central India, and district Mandla of Madhya Pradesh

“…The comprehensive surveillance strategy provided a robust estimate of malaria cases in Mandla district as compared to the rest of the state and the country. The MEDP also implemented MSaT to diagnose and treat the asymptomatic malaria cases during 2018–2020 and adopted the stratified clustered sampling method based on the malaria endemicity ( 12 ). Therefore, the Mandla malaria estimates were a true “total” burden of malaria as compared to the state of MP and the rest of the country.…”

Science of malaria elimination: using knowledge of bottlenecks and enablers from the Malaria Elimination Demonstration Project in Central India for eliminating malaria in the Asia Pacific region

“…Additionally, the prevalence of malaria in febrile cases detected by PCR was 2.50% (436/17,405) vs. 1.13% (196/17,405) by RDT. A statistically significant ( p < 0.001) increase in the number of LDMI cases was observed among subjects with a mean duration of fever of 3 days ( 11 , 13 ).…”

“…MEDP integrated the Mass Screening and Treatment (MSaT) strategy in its surveillance and case management toolkit. In the absence of concrete national guidelines for MSaT, the project tested Cluster Combination Approaches (CCA) to generate evidence on the role of LDMIs in malaria transmission in Mandla district ( 13 ). The CCA screened the entire population (irrespective of malaria symptoms) within a defined geographical area with varying endemicities and hard-to-reach areas.…”

Assessment of Plasmodium falciparum drug resistance associated molecular markers in Mandla, Madhya Pradesh, India

“…1 ) and 1233 villages; the total population is 1,140,765 population [ 18 ]. Dried blood spots were collected from finger pricks as described previously during the active door-to-door fever survey [ 20 ] and Mass Screening and Treatment (MSaT) strategies [ 21 ] during 2019–2020. The detailed methodology of sample collections and results of malaria diagnosis using rapid diagnostic tests, microscopic smear examinations, and Polymerase Chain Reaction (PCR) findings were reported elsewhere [ 20 – 22 ].…”