Determining the Impact of Scaling up Mass Testing, Treatment and Tracking on Malaria Prevalence in Ghana
Status:
Recruiting
Trial end date:
2022-01-31
Target enrollment:
Participant gender:
Summary
Globally, malaria prevalence in 2016 was reported to have increased with 445,000 deaths, 91%
of which occurred in sub-Sahara Africa with more than 75% being children. Individuals who
carry the malaria parasite can either be symptomatic (showing signs and symptoms) or
asymptomatic (without signs and symptoms). Asymptomatic malaria parasitaemia pose a very
serious threat to malaria control efforts as they serve as reservoirs that fuel the
transmission process. Therefore, interventions that target community-wide clearance of
asymptomatic parasitaemia can drastically reduce malaria prevalence in the population and
lead to elimination especially in endemic areas. Mass parasite clearance can deplete the
parasite reservoirs and lower the transmission potential.
Efforts are ongoing to scale-up interventions that work such as use of Long Lasting
Insecticidal Nets (LLIN), Intermittent Preventive Treatment in children (IPTc), and test,
treat and track (TTT). However, there is need for mass testing, treatment and tracking (MTTT)
of the whole population to reduce the parasite load before implementing the aforementioned
interventions. Though, Seasonal Malaria Chemoprophylaxis (SMC) is adopted for selected
localities in Ghana, the impact of such interventions could be enhanced, if combined with
MTTT at baseline to reduce the parasite load. IPT of children in Ghana has demonstrated a
parasite load reduction from 25% to 1%. However, unanswered questions include - could this be
scaled up? What can be the coverage? What is needed for MTTT scale -up? In a pilot in Ghana,
a coverage of more than 75% was achieved in target communities and reduced asymptomatic
parasitaemia by 24% from July 2017 to July 2018. It is important to generate time series data
to better analyse and understand the prevalence trends as well as the bottlenecks.
In designing interventions that aim at reducing the burden of malaria in children under five,
for example, MTTT has largely been left out. This study explores the scale-up of
interventions that work using community volunteers, hypothesising that implementing MTTT
complemented by community-based management can reduce the prevalence of asymptomatic malaria
parasite carriage in endemic communities. The effect of the interventions will be observed by
comparing baseline data to evaluation data. This study will document the challenges and
bottlenecks associated with scaling-up of MTTT to inform future efforts to scale-up the
intervention.
Phase:
N/A
Details
Lead Sponsor:
Noguchi Memorial Institute for Medical Research
Collaborators:
Communities Ghana National Malaria Control Programme