Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study
Background: Mass drug administration for elimination of Plasmodium falciparum malaria is recommended by WHO in some settings. We used consensus modelling to understand how to optimise the effects of mass drug administration in areas with low malaria transmission. Methods: We collaborated with resear...
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Elsevier
2017-07-01
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Series: | The Lancet Global Health |
Online Access: | http://www.sciencedirect.com/science/article/pii/S2214109X17302206 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Oliver J Brady, DPhil Hannah C Slater, PhD Peter Pemberton-Ross, PhD Edward Wenger, PhD Richard J Maude, MD Prof Azra C Ghani, PhD Melissa A Penny, PhD Jaline Gerardin, PhD Prof Lisa J White, PhD Nakul Chitnis, PhD Ricardo Aguas, PhD Simon I Hay, DSc Prof David L Smith, PhD Erin M Stuckey, PhD Emelda A Okiro, PhD Prof Thomas A Smith, PhD Dr Lucy C Okell, PhD |
spellingShingle |
Oliver J Brady, DPhil Hannah C Slater, PhD Peter Pemberton-Ross, PhD Edward Wenger, PhD Richard J Maude, MD Prof Azra C Ghani, PhD Melissa A Penny, PhD Jaline Gerardin, PhD Prof Lisa J White, PhD Nakul Chitnis, PhD Ricardo Aguas, PhD Simon I Hay, DSc Prof David L Smith, PhD Erin M Stuckey, PhD Emelda A Okiro, PhD Prof Thomas A Smith, PhD Dr Lucy C Okell, PhD Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study The Lancet Global Health |
author_facet |
Oliver J Brady, DPhil Hannah C Slater, PhD Peter Pemberton-Ross, PhD Edward Wenger, PhD Richard J Maude, MD Prof Azra C Ghani, PhD Melissa A Penny, PhD Jaline Gerardin, PhD Prof Lisa J White, PhD Nakul Chitnis, PhD Ricardo Aguas, PhD Simon I Hay, DSc Prof David L Smith, PhD Erin M Stuckey, PhD Emelda A Okiro, PhD Prof Thomas A Smith, PhD Dr Lucy C Okell, PhD |
author_sort |
Oliver J Brady, DPhil |
title |
Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study |
title_short |
Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study |
title_full |
Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study |
title_fullStr |
Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study |
title_full_unstemmed |
Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study |
title_sort |
role of mass drug administration in elimination of plasmodium falciparum malaria: a consensus modelling study |
publisher |
Elsevier |
series |
The Lancet Global Health |
issn |
2214-109X |
publishDate |
2017-07-01 |
description |
Background: Mass drug administration for elimination of Plasmodium falciparum malaria is recommended by WHO in some settings. We used consensus modelling to understand how to optimise the effects of mass drug administration in areas with low malaria transmission.
Methods: We collaborated with researchers doing field trials to establish a standard intervention scenario and standard transmission setting, and we input these parameters into four previously published models. We then varied the number of rounds of mass drug administration, coverage, duration, timing, importation of infection, and pre-administration transmission levels. The outcome of interest was the percentage reduction in annual mean prevalence of P falciparum parasite rate as measured by PCR in the third year after the final round of mass drug administration.
Findings: The models predicted differing magnitude of the effects of mass drug administration, but consensus answers were reached for several factors. Mass drug administration was predicted to reduce transmission over a longer timescale than accounted for by the prophylactic effect alone. Percentage reduction in transmission was predicted to be higher and last longer at lower baseline transmission levels. Reduction in transmission resulting from mass drug administration was predicted to be temporary, and in the absence of scale-up of other interventions, such as vector control, transmission would return to pre-administration levels. The proportion of the population treated in a year was a key determinant of simulated effectiveness, irrespective of whether people are treated through high coverage in a single round or new individuals are reached by implementation of several rounds. Mass drug administration was predicted to be more effective if continued over 2 years rather than 1 year, and if done at the time of year when transmission is lowest.
Interpretation: Mass drug administration has the potential to reduce transmission for a limited time, but is not an effective replacement for existing vector control. Unless elimination is achieved, mass drug administration has to be repeated regularly for sustained effect.
Funding: Bill & Melinda Gates Foundation. |
url |
http://www.sciencedirect.com/science/article/pii/S2214109X17302206 |
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doaj-90a852f11f5746a7846a49c8e66a7aac2020-11-25T01:11:09ZengElsevierThe Lancet Global Health2214-109X2017-07-0157e680e68710.1016/S2214-109X(17)30220-6Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling studyOliver J Brady, DPhil0Hannah C Slater, PhD1Peter Pemberton-Ross, PhD2Edward Wenger, PhD3Richard J Maude, MD4Prof Azra C Ghani, PhD5Melissa A Penny, PhD6Jaline Gerardin, PhD7Prof Lisa J White, PhD8Nakul Chitnis, PhD9Ricardo Aguas, PhD10Simon I Hay, DSc11Prof David L Smith, PhD12Erin M Stuckey, PhD13Emelda A Okiro, PhD14Prof Thomas A Smith, PhD15Dr Lucy C Okell, PhD16Centre for the Mathematical Modelling of Infectious Diseases, Department of Infectious Disease Epidemiology, and Malaria Modelling Consortium, London School of Hygiene & Tropical Medicine, London, UKMRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College, London, UKSwiss Tropical and Public Health Institute, Basel, SwitzerlandInstitute for Disease Modeling, Bellevue, WA, USAMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, ThailandMRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College, London, UKSwiss Tropical and Public Health Institute, Basel, SwitzerlandInstitute for Disease Modeling, Bellevue, WA, USAMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, ThailandSwiss Tropical and Public Health Institute, Basel, SwitzerlandMahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, ThailandOxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UKInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USAMalaria Modelling Consortium, Bill & Melinda Gates Foundation, Seattle, WA, USAMalaria Modelling Consortium, Bill & Melinda Gates Foundation, Seattle, WA, USASwiss Tropical and Public Health Institute, Basel, SwitzerlandMRC Centre for Outbreak Analysis and Modelling, Department of Infectious Disease Epidemiology, Imperial College, London, UKBackground: Mass drug administration for elimination of Plasmodium falciparum malaria is recommended by WHO in some settings. We used consensus modelling to understand how to optimise the effects of mass drug administration in areas with low malaria transmission. Methods: We collaborated with researchers doing field trials to establish a standard intervention scenario and standard transmission setting, and we input these parameters into four previously published models. We then varied the number of rounds of mass drug administration, coverage, duration, timing, importation of infection, and pre-administration transmission levels. The outcome of interest was the percentage reduction in annual mean prevalence of P falciparum parasite rate as measured by PCR in the third year after the final round of mass drug administration. Findings: The models predicted differing magnitude of the effects of mass drug administration, but consensus answers were reached for several factors. Mass drug administration was predicted to reduce transmission over a longer timescale than accounted for by the prophylactic effect alone. Percentage reduction in transmission was predicted to be higher and last longer at lower baseline transmission levels. Reduction in transmission resulting from mass drug administration was predicted to be temporary, and in the absence of scale-up of other interventions, such as vector control, transmission would return to pre-administration levels. The proportion of the population treated in a year was a key determinant of simulated effectiveness, irrespective of whether people are treated through high coverage in a single round or new individuals are reached by implementation of several rounds. Mass drug administration was predicted to be more effective if continued over 2 years rather than 1 year, and if done at the time of year when transmission is lowest. Interpretation: Mass drug administration has the potential to reduce transmission for a limited time, but is not an effective replacement for existing vector control. Unless elimination is achieved, mass drug administration has to be repeated regularly for sustained effect. Funding: Bill & Melinda Gates Foundation.http://www.sciencedirect.com/science/article/pii/S2214109X17302206 |