The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia: A cluster randomised trial

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von Seidlein, LorenzMahidol Univ, Thailand; Univ Oxford, England (författare)

The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia: A cluster randomised trial

Artikel/kapitelEngelska2019

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2019-02-15
PUBLIC LIBRARY SCIENCE,2019
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LIBRIS-ID:oai:DiVA.org:liu-155583
https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-155583URI
https://doi.org/10.1371/journal.pmed.1002745DOI

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Språk:engelska
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Funding Agencies|Wellcome Trust [101148/Z/13/Z]; Bill and Melinda Gates Foundation [OPP1081420]; National Health and Medical Research Council [1104975]
Background The emergence and spread of multidrug-resistant Plasmodium falciparum in the Greater Mekong Subregion (GMS) threatens global malaria elimination efforts. Mass drug administration (MDA), the presumptive antimalarial treatment of an entire population to clear the subclinical parasite reservoir, is a strategy to accelerate malaria elimination. We report a cluster randomised trial to assess the effectiveness of dihydroartemisinin-piperaquine (DP) MDA in reducing falciparum malaria incidence and prevalence in 16 remote village populations in Myanmar, Vietnam, Cambodia, and the Lao Peoples Democratic Republic, where artemisinin resistance is prevalent. Methods and findings After establishing vector control and community-based case management and following intensive community engagement, we used restricted randomisation within village pairs to select 8 villages to receive early DP MDA and 8 villages as controls for 12 months, after which the control villages received deferred DP MDA. The MDA comprised 3 monthly rounds of 3 daily doses of DP and, except in Cambodia, a single low dose of primaquine. We conducted exhaustive cross-sectional surveys of the entire population of each village at quarterly intervals using ultrasensitive quantitative PCR to detect Plasmodium infections. The study was conducted between May 2013 and July 2017. The investigators randomised 16 villages that had a total of 8,445 residents at the start of the study. Of these 8,445 residents, 4,135 (49%) residents living in 8 villages, plus an additional 288 newcomers to the villages, were randomised to receive early MDA; 3,790 out of the 4,423 (86%) participated in at least 1 MDA round, and 2,520 out of the 4,423 (57%) participated in all 3 rounds. The primary outcome, P. falciparum prevalence by month 3 (M3), fell by 92% (from 5.1% [171/3,340] to 0.4% [12/2,828]) in early MDA villages and by 29% (from 7.2% [246/3,405] to 5.1% [155/3,057]) in control villages. Over the following 9 months, the P. falciparum prevalence increased to 3.3% (96/2,881) in early MDA villages and to 6.1% (128/2,101) in control villages (adjusted incidence rate ratio 0.41 [95% CI 0.20 to 0.84]; p = 0.015). Individual protection was proportional to the number of completed MDA rounds. Of 221 participants with subclinical P. falciparum infections who participated in MDA and could be followed up, 207 (94%) cleared their infections, including 9 of 10 with artemisinin-and piperaquine- resistant infections. The DP MDAs were well tolerated; 6 severe adverse events were detected during the follow-up period, but none was attributable to the intervention. Conclusions Added to community-based basic malaria control measures, 3 monthly rounds of DP MDA reduced the incidence and prevalence of falciparum malaria over a 1-year period in areas affected by artemisinin resistance. P. falciparum infections returned during the follow-up period as the remaining infections spread and malaria was reintroduced from surrounding areas. Limitations of this study include a relatively small sample of villages, heterogeneity between villages, and mobility of villagers that may have limited the impact of the intervention. These results suggest that, if used as part of a comprehensive, well-organised, and well-resourced elimination programme, DP MDA can be a useful additional tool to accelerate malaria elimination.

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Peto, Thomas J.Mahidol Univ, Thailand; Univ Oxford, England (författare)
Landier, JordiMahidol Univ, Thailand; Aix Marseille Univ, France (författare)
Nguyen, Thuy-NhienWellcome Trust Major Overseas Programmes, Vietnam (författare)
Tripura, RupamMahidol Univ, Thailand; Univ Oxford, England; Univ Amsterdam, Netherlands (författare)
Phommasone, KoukeoMahosot Hosp, Laos; Amsterdam Inst Global Hlth and Dev, Netherlands (författare)
Pongvongsa, TiengkhamSavannakhet Prov Hlth Dept, Laos; Mahidol Univ, Thailand (författare)
Lwin, Khin MaungMahidol Univ, Thailand (författare)
Keereecharoen, LillyMahidol Univ, Thailand (författare)
Kajeechiwa, LaddaMahidol Univ, Thailand (författare)
Thwin, May MyoMahidol Univ, Thailand (författare)
Parker, Daniel M.Mahidol Univ, Thailand; Univ Calif Irvine, CA USA (författare)
Wiladphaingern, JacherMahidol Univ, Thailand (författare)
Nosten, SuphakMahidol Univ, Thailand (författare)
Proux, StephaneMahidol Univ, Thailand (författare)
Corbel, VincentUniv Montpellier, France (författare)
Tuong-Vy, NguyenWellcome Trust Major Overseas Programmes, Vietnam (författare)
Phuc-Nhi, Truong LeWellcome Trust Major Overseas Programmes, Vietnam (författare)
Hung Son, DoWellcome Trust Major Overseas Programmes, Vietnam (författare)
Nguyen Huong-Thu, PhamWellcome Trust Major Overseas Programmes, Vietnam (författare)
Thi Kim Tuyen, NguyenWellcome Trust Major Overseas Programmes, Vietnam (författare)
Thanh Tien, NguyenWellcome Trust Major Overseas Programmes, Vietnam (författare)
Dong, Le ThanhInst Malariol Parasitol and Entomol, Vietnam (författare)
Van Hue, DaoCtr Malariol Parasitol and Entomol, Vietnam (författare)
Hong Quang, HuynhInst Malariol Parasitol and Entomol, Vietnam (författare)
Nguon, CheaNatl Ctr Parasitol Entomol and Malaria Control, Cambodia (författare)
Davoeung, ChanProv Hlth Dept, Cambodia (författare)
Rekol, HuyNatl Ctr Parasitol Entomol and Malaria Control, Cambodia (författare)
Adhikari, BipinMahidol Univ, Thailand; Univ Oxford, England (författare)
Henriques, GiselaMahidol Univ, Thailand; London Sch Hyg and Trop Med, England (författare)
Phongmany, PanomSavannakhet Prov Hlth Dept, Laos (författare)
Suangkanarat, PreyananMahosot Hosp, Laos (författare)
Jeeyapant, AtthaneeMahidol Univ, Thailand (författare)
Vihokhern, BenchawanMahidol Univ, Thailand (författare)
van der Pluijm, Rob W.Mahidol Univ, Thailand; Univ Oxford, England (författare)
Lubell, YoelMahidol Univ, Thailand; Univ Oxford, England (författare)
White, Lisa J.Mahidol Univ, Thailand; Univ Oxford, England (författare)
Aguas, RicardoMahidol Univ, Thailand; Univ Oxford, England (författare)
Promnarate, CholraweeMahidol Univ, Thailand; Mahidol Univ, Thailand (författare)
Sirithiranont, PasathornMahidol Univ, Thailand (författare)
Malleret, BenoitNatl Univ Singapore, Singapore; Agcy Sci Technol and Res, Singapore (författare)
Renia, LaurentAgcy Sci Technol and Res, Singapore (författare)
Onsjö, CarlLinköpings universitet,Medicinska fakulteten,Mahidol Univ, Thailand(Swepub:liu)n/a (författare)
Chan, Xin HuiMahidol Univ, Thailand; Univ Oxford, England (författare)
Chalk, JeremyMahidol Univ, Thailand (författare)
Miotto, OlivoMahidol Univ, Thailand; Wellcome Trust Sanger Inst, England (författare)
Patumrat, KrittayaMahidol Univ, Thailand (författare)
Chotivanich, KesineeMahidol Univ, Thailand; Mahidol Univ, Thailand (författare)
Hanboonkunupakarn, BorimasMahidol Univ, Thailand (författare)
Jittmala, PodjaneeMahidol Univ, Thailand (författare)
Kaehler, NilsMahidol Univ, Thailand (författare)
Cheah, Phaik YeongMahidol Univ, Thailand; Univ Oxford, England (författare)
Pell, ChristopherAmsterdam Inst Global Hlth and Dev, Netherlands (författare)
Dhorda, MehulMahidol Univ, Thailand (författare)
Imwong, MallikaMahidol Univ, Thailand (författare)
Snounou, GeorgesUniv Paris Sud 11, France (författare)
Mukaka, MavutoMahidol Univ, Thailand; Univ Oxford, England (författare)
Peerawaranun, PimnaraMahidol Univ, Thailand (författare)
Lee, Sue J.Mahidol Univ, Thailand; Univ Oxford, England (författare)
Simpson, Julie A.Univ Melbourne, Australia (författare)
Pukrittayakamee, SasithonMahidol Univ, Thailand; Mahidol Univ, Thailand; Royal Soc Thailand, Thailand (författare)
Singhasivanon, PratapMahidol Univ, Thailand (författare)
Grobusch, Martin P.Univ Amsterdam, Netherlands (författare)
Cobelens, FrankAmsterdam Inst Global Hlth and Dev, Netherlands (författare)
Smithuis, FrankMyanmar Oxford Clin Res Unit, Myanmar (författare)
Newton, Paul N.Univ Oxford, England; Mahosot Hosp, Laos (författare)
Thwaites, Guy E.Univ Oxford, England; Wellcome Trust Major Overseas Programmes, Vietnam (författare)
Day, Nicholas P. J.Mahidol Univ, Thailand; Univ Oxford, England (författare)
Mayxay, MayfongMahosot Hosp, Laos; Univ Hlth Sci, Laos (författare)
Tinh Hien, TranUniv Oxford, England; Aix Marseille Univ, France (författare)
Nosten, Francois H.Univ Oxford, England; Mahidol Univ, Thailand (författare)
Dondorp, Arjen M.Mahidol Univ, Thailand; Univ Oxford, England (författare)
White, Nicholas J.Mahidol Univ, Thailand; Univ Oxford, England (författare)
Mahidol Univ, Thailand; Univ Oxford, EnglandMahidol Univ, Thailand; Aix Marseille Univ, France (creator_code:org_t)

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Av författaren/redakt...: von Seidlein, Lo ...; Peto, Thomas J.; Landier, Jordi; Nguyen, Thuy-Nhi ...; Tripura, Rupam; Phommasone, Kouk ...; visa fler...; Pongvongsa, Tien ...; Lwin, Khin Maung; Keereecharoen, L ...; Kajeechiwa, Ladd ...; Thwin, May Myo; Parker, Daniel M ...; Wiladphaingern, ...; Nosten, Suphak; Proux, Stephane; Corbel, Vincent; Tuong-Vy, Nguyen; Phuc-Nhi, Truong ...; Hung Son, Do; Nguyen Huong-Thu ...; Thi Kim Tuyen, N ...; Thanh Tien, Nguy ...; Dong, Le Thanh; Van Hue, Dao; Hong Quang, Huyn ...; Nguon, Chea; Davoeung, Chan; Rekol, Huy; Adhikari, Bipin; Henriques, Gisel ...; Phongmany, Panom; Suangkanarat, Pr ...; Jeeyapant, Attha ...; Vihokhern, Bench ...; van der Pluijm, ...; Lubell, Yoel; White, Lisa J.; Aguas, Ricardo; Promnarate, Chol ...; Sirithiranont, P ...; Malleret, Benoit; Renia, Laurent; Onsjö, Carl; Chan, Xin Hui; Chalk, Jeremy; Miotto, Olivo; Patumrat, Kritta ...; Chotivanich, Kes ...; Hanboonkunupakar ...; Jittmala, Podjan ...; Kaehler, Nils; Cheah, Phaik Yeo ...; Pell, Christophe ...; Dhorda, Mehul; Imwong, Mallika; Snounou, Georges; Mukaka, Mavuto; Peerawaranun, Pi ...; Lee, Sue J.; Simpson, Julie A ...; Pukrittayakamee, ...; Singhasivanon, P ...; Grobusch, Martin ...; Cobelens, Frank; Smithuis, Frank; Newton, Paul N.; Thwaites, Guy E.; Day, Nicholas P. ...; Mayxay, Mayfong; Tinh Hien, Tran; Nosten, Francois ...; Dondorp, Arjen M ...; White, Nicholas ...; visa färre...

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