Transitioning from malaria control to elimination: the vital role of ACTs

Grueninger, Heiner; Hamed, Kamal

doi:10.1016/j.pt.2012.11.002

Cited by 20 publications

(16 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, they have been used to detect local foci of asymptomatic infection in Zambia [15]. Administration of treatment to asymptomatic carriers surrounding index cases forms the basis of the ‘focal screening and treatment’ strategy for malaria control and elimination [16]. …”

Section: Discussionmentioning

confidence: 99%

A controlled, parallel, cluster-randomized trial of community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso

Tiono

Ouédraogo

Ogutu

et al. 2013

Malar J

Self Cite

119

View full text Add to dashboard Cite

BackgroundIn malaria-endemic countries, large proportions of infected individuals are asymptomatic, constituting a reservoir of parasites for infection of newly hatched mosquitoes. This study evaluated the impact of screening and treatment of asymptomatic carriers of Plasmodium falciparum.MethodsEighteen villages were randomized (1:1) to study arms and inhabitants participated in four community screening campaigns: three before the rainy season ~1 month apart, and the fourth after the rains at ~12 months. On day 1 of campaigns 1–3, asymptomatic carriers in the intervention arm were identified by rapid diagnostic test and treated with artemether-lumefantrine. Outcomes were symptomatic malaria with parasite density >5,000/μL per person-year in children < 5 years and change in haemoglobin between days 1 and 28 of campaign 1.ResultsAt 12 months, the number of symptomatic malaria episodes with a parasite density >5,000/μL per person-year in children < 5 years was not significantly different between arms (1.69 vs 1.60, p = 0.3482). Mean haemoglobin change in asymptomatic carriers during campaign 1 was greater in the intervention vs control arm (+0.53 g/dL vs -0.21 g/dL, p < 0.0001). ANCOVA demonstrated that mean asymptomatic carriage at the cluster level was lower in the intervention vs control arm at day 1 of campaigns 2 (5.0% vs 34.9%, p < 0.0001) and 3 (3.5% vs 31.5%, p < 0.0001), but showed only a small difference at day 1 of campaign 4 (34.6% vs 37.6%, p = 0.2982). Mean gametocyte carriage was lower in the intervention vs control arm at day 1 of campaigns 2 and 3 (0.7% vs 5.4%, p < 0.0001; 0.5% vs 5.8%, p < 0.0001), but was similar at day 1 of campaign 4 (4.9% vs 5.1%, p = 0.7208).ConclusionsSystematic screening and treatment of asymptomatic carriers at the community level did not reduce clinical malaria incidence in the subsequent transmission season, indicating greater levels of parasite clearance are required to achieve a sustained impact in this setting.

show abstract

Section: Discussionmentioning

confidence: 99%

A controlled, parallel, cluster-randomized trial of community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso

Tiono

Ouédraogo

Ogutu

et al. 2013

Malar J

Self Cite

119

View full text Add to dashboard Cite

show abstract

“…Moreover, several other public health intervention strategies are also being implemented [5-7]. As countries move towards malaria elimination, limiting transmission of the disease will be critical.…”

Section: Introductionmentioning

confidence: 99%

“…ACT forms the cornerstone of WHO-recommended treatment for uncomplicated P. falciparum malaria [16], and will undoubtedly play a vital role in malaria elimination strategies [7]. An important feature of artemisinin derivatives, that complements their high efficacy against asexual plasmodium parasites, is their gametocytocidal properties; ACT can shorten the duration of gametocyte carriage by approximately four-fold [17].…”

Section: Introductionmentioning

confidence: 99%

A review of the effects of artemether-lumefantrine on gametocyte carriage and disease transmission

Makanga¹

2014

Malar J

View full text Add to dashboard Cite

While significant advances have been made in the prevention and treatment of malaria in recent years, these successes continue to fall short of the World Health Organization (WHO) goals for malaria control and elimination. For elimination strategies to be effective, limited disease transmission, achieved through rapid reduction in the infectious parasite reservoir and decreased gametocyte carriage, will be critical. Artemisinin-based combination therapy (ACT) forms the cornerstone of WHO-recommended treatment for uncomplicated Plasmodium falciparum malaria, and in combination with other effective interventions will undoubtedly play a vital role in elimination programmes. The gametocytocidal properties of artemisinins are a bonus attribute; there is epidemiological evidence of reductions in malaria incidence and transmission in African regions since the introduction of these agents. Many studies and analyses have specifically investigated the effects of the ACT, artemether-lumefantrine (AL) on gametocyte carriage. In this systematic review of 62 articles published between 1998 and January 2014, the effects of AL on gametocyte carriage and malaria transmission are compared with other artemisinin-based anti-malarials and non-ACT. The impact of AL treatment of asymptomatic carriers on population gametocyte carriage, and the potential future role of AL in malaria elimination initiatives are also considered. Despite the inherent difficulties in comparing data from a range of different studies that also utilized different diagnostic approaches to assess baseline gametocyte counts, the gametocytocidal effect of AL was proportionately consistent across the studies reviewed, suggesting that AL will continue to play a vital role in the treatment of malaria and contribute to clearing the path towards malaria elimination. However, the specific place of AL is the subject of much ongoing research and will undoubtedly be dependent on different demographic and geographical scenarios. Utilizing ACT, such as AL, within malaria elimination strategies is also associated with a number of other challenges, such as balancing potential increased use of ACT (e g, treatment of asymptomatic carriers and home-based treatment) with rational use and avoidance of drug resistance development.

show abstract

“…[1] However, the widespread deployment of artemisinin derivatives in combination therapy and renewed efforts at mosquito control have revived the global mission to eradicate malaria. [2] Sri Lanka, which was declared malaria free in 2016, is a success story in the South Asia region. [3] The Indian government, too, supports this initiative with the publication of a roadmap to malaria elimination by 2030.…”

Section: Introductionmentioning

confidence: 99%

Malaria in India: The Need for New Targets for Diagnosis and Detection of Plasmodium vivax

Patankar

Sharma

Rathod

et al. 2018

Proteomics Clinical Apps

View full text Add to dashboard Cite

Plasmodium vivax is a protozoan parasite that is one of the causative agents of human malaria. Due to several occult features of its life cycle, P. vivax threatens to be a problem for the recent efforts toward elimination of malaria globally. With an emphasis on malaria elimination goals, the authors summarize the major gaps in P. vivax diagnosis and describe how proteomics technologies have begun to contribute toward the discovery of antigens that could be used for various technology platforms and applications. The authors suggest areas where, in the future, proteomics technologies could fill in gaps in P. vivax diagnosis that have proved difficult. The discovery of new parasite antigens, host responses, and immune signatures using proteomics technologies will be a key part of the global malaria elimination efforts.

show abstract

Transitioning from malaria control to elimination: the vital role of ACTs

Cited by 20 publications

References 35 publications

A controlled, parallel, cluster-randomized trial of community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso

A controlled, parallel, cluster-randomized trial of community-wide screening and treatment of asymptomatic carriers of Plasmodium falciparum in Burkina Faso

A review of the effects of artemether-lumefantrine on gametocyte carriage and disease transmission

Malaria in India: The Need for New Targets for Diagnosis and Detection of Plasmodium vivax

Contact Info

Product

Resources

About