Mass-Drug Administration to Reduce Malaria Transmission
Status:
Completed
Trial end date:
2008-08-01
Target enrollment:
Participant gender:
Summary
In the 1950s, the WHO included mass drug administration (MDA) with antimalarial drugs as a
tool for malaria control in 'exceptional conditions when conventional control strategies have
failed'. Subsequently, MDA has received little attention until the introduction of
artemisinin based combination therapy (ACT). The principle aim of MDA is to interrupt malaria
transmission by clearing the population of sexual stage parasites, gametocytes, prior to the
transmission season. Gametocytes are essential for propagation of the disease and elimination
of gametocytes will result in a reduction in malaria transmission. As a consequence, a
successful MDA will reduce the burden of disease in a population and is expected to have
little influence on the development of protective immunity in areas of low transmission
intensity. In Africa, only one large scale MDA study was conducted in the last 10 years. That
study, conducted in The Gambia using sulphadoxine-pyrimethamine (SP) plus a single dose of
artesunate (AS), failed to show a significant impact of MDA on malaria transmission. Possible
reasons for this failure are the limited impact of the drug regimen (a single dose of AS) on
malaria transmission, the incomplete coverage, the relatively high transmission intensity in
the area and the migration of individuals between villages. Here, we propose to conduct an
MDA study in an area of very low malaria transmission intensity in Tanzania. We use the
highly active drug combination SP+AS (3 days) followed by a single dose of primaquine..
Phase:
N/A
Details
Lead Sponsor:
Radboud University
Collaborators:
Kilimanjaro Christian Medical Centre, Tanzania London School of Hygiene and Tropical Medicine
Treatments:
Artesunate Fanasil, pyrimethamine drug combination Primaquine Pyrimethamine Sulfadoxine