A cluster-randomized trial of mass drug administration with a gametocytocidal drug combination to interrupt malaria transmission in a low endemic area in Tanzania
| العنوان: | A cluster-randomized trial of mass drug administration with a gametocytocidal drug combination to interrupt malaria transmission in a low endemic area in Tanzania |
|---|---|
| المؤلفون: | Teun Bousema, Alutu Masokoto, Lucy C Okell, Chris Drakeley, Salimu Semvua, Rob Hermsen, Robert W. Sauerwein, Sven van den Bosch, Seif Shekalaghe, Karina Teelen, Charles Mwanziva, Roly Gosling, Roel ter Braak, Frank W. Mosha, Wouter van den Bijllaardt |
| المصدر: | Malaria Journal, Vol 10, Iss 1, p 247 (2011) Malaria Journal, 10, 247-247 Malaria Journal, 10, pp. 247-247 Malaria Journal |
| سنة النشر: | 2011 |
| مصطلحات موضوعية: | Male, Primaquine, Endemic Diseases, medicine.medical_treatment, Artesunate, Parasitemia, Tanzania, Placebos, chemistry.chemical_compound, 0302 clinical medicine, 1108 Medical Microbiology, Medicine, 030212 general & internal medicine, Child, Aged, 80 and over, Microscopy, biology, Middle Aged, Artemisinins, 3. Good health, Drug Combinations, Infectious Diseases, Pyrimethamine, Treatment Outcome, Child, Preschool, Drug Therapy, Combination, Female, medicine.drug, Adult, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, Adolescent, Sulfadoxine, lcsh:RC955-962, 030231 tropical medicine, lcsh:Infectious and parasitic diseases, 03 medical and health sciences, Antimalarials, Young Adult, Internal medicine, Tropical Medicine, parasitic diseases, Humans, lcsh:RC109-216, Mass drug administration, Aged, business.industry, Research, Infant, Pathogenesis and modulation of inflammation Infection and autoimmunity [N4i 1], medicine.disease, biology.organism_classification, Malaria, chemistry, Immunology, Parasitology, business |
| الوصف: | Background Effective mass drug administration (MDA) with anti-malarial drugs can clear the human infectious reservoir for malaria and thereby interrupt malaria transmission. The likelihood of success of MDA depends on the intensity and seasonality of malaria transmission, the efficacy of the intervention in rapidly clearing all malaria parasite stages and the degree to which symptomatic and asymptomatic parasite carriers participate in the intervention. The impact of MDA with the gametocytocidal drug combination sulphadoxine-pyrimethamine (SP) plus artesunate (AS) plus primaquine (PQ, single dose 0.75 mg/kg) on malaria transmission was determined in an area of very low and seasonal malaria transmission in northern Tanzania. Methods In a cluster-randomized trial in four villages in Lower Moshi, Tanzania, eight clusters (1,110 individuals; cluster size 47- 209) were randomized to observed treatment with SP+AS+PQ and eight clusters (2,347 individuals, cluster size 55- 737) to treatment with placebo over three days. Intervention and control clusters were 1km apart; households that were located between clusters were treated as buffer zones where all individuals received SP+AS+PQ but were not selected for the evaluation. Passive case detection was done for the entire cohort and active case detection in 149 children aged 1-10 year from the intervention arm and 143 from the control arm. Four cross-sectional surveys assessed parasite carriage by microscopy and molecular methods during a five-month follow-up period. Results The coverage rate in the intervention arm was 93.0% (1,117/1,201). Parasite prevalence by molecular detection methods was 2.2-2.7% prior to the intervention and undetectable during follow-up in both the control and intervention clusters. None of the slides collected during cross-sectional surveys had microscopically detectable parasite densities. Three clinical malaria episodes occurred in the intervention (n = 1) and control clusters (n = 2). Conclusions This study illustrates the possibility to achieve high coverage with a three-day intervention but also the difficulty in defining suitable outcome measures to evaluate interventions in areas of very low malaria transmission intensity. The decline in transmission intensity prior to the intervention made it impossible to assess the impact of MDA in the chosen study setting. Trial Registration ClinicalTrials.gov: NCT00509015 |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1475-2875 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b88e3b659f27a163d2043b5479d249c6 http://hdl.handle.net/10044/1/56143 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....b88e3b659f27a163d2043b5479d249c6 |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 14752875 |
|---|