scholarly journals The promise, problems and pitfalls of mass drug administration for malaria elimination: a qualitative study with scientists and policymakers

2018 ◽  
Vol 11 (3) ◽  
pp. 166-176 ◽  
Author(s):  
Nils Kaehler ◽  
Bipin Adhikari ◽  
Phaik Yeong Cheah ◽  
Nicholas P J Day ◽  
Daniel H Paris ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Malaria Elimination ◽  
Artemisinin Resistance ◽  
Malaria Prevention ◽  
Evidence Base ◽  
World Health ◽  
Pilot Studies ◽  
Target Populations ◽  
Health Organization

Abstract Background The emergence of artemisinin resistance in the Greater Mekong Subregion (GMS) has prompted urgent containment measures. One possible approach is mass drug administration (MDA). This article explores attitudes towards and perceptions of MDA for malaria elimination among policymakers and leading malariologists. Methods Thirty-two semistructured interviews (SSI) were conducted with policymakers (n=17) and principal investigators (n=15) selected based on their involvement in malaria prevention, control and elimination in the GMS. Interviews were audio recorded and transcribed for qualitative content (thematic) analysis using NVivo (QSR International, Doncaster, Victoria, Australia). Results Researchers and policymakers described reluctance and consequently delays to pilot MDA for malaria elimination. Most policymakers and some researchers reported concerns around the evidence base, citing a lack of data on its effectiveness and appropriate target populations. There were also worries about promoting resistance. Other issues included a previous lack of support from the World Health Organization, past MDAs, the remoteness of target populations and challenges explaining the rationale for MDA. Conclusions The complex rationale for MDA for malaria elimination, mistaking pilot studies for implementation, past experiences with MDA, difficulties in selecting appropriate sites and the WHO’s lack of clear backing undermined the support for MDA for malaria elimination.

scholarly journals A community survey of coverage and adverse events following country-wide triple-drug mass drug administration for lymphatic filariasis elimination, Samoa 2018

2020 ◽  
Vol 14 (11) ◽  
pp. e0008854
Author(s):  
Gabriela A. Willis ◽  
Helen J. Mayfield ◽  
Therese Kearns ◽  
Take Naseri ◽  
Robert Thomsen ◽  
...  
Keyword(s):  
Adverse Events ◽  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Total Population ◽  
Community Survey ◽  
World Health ◽  
Cross Sectional ◽  
Eligible Population ◽  
Health Organization

The Global Programme to Eliminate Lymphatic Filariasis has made considerable progress but is experiencing challenges in meeting targets in some countries. Recent World Health Organization guidelines have recommended two rounds of triple-drug therapy with ivermectin, diethylcarbamazine (DEC), and albendazole (IDA), in areas where mass drug administration (MDA) results with two drugs (DEC and albendazole) have been suboptimal, as is the case in Samoa. In August 2018, Samoa was the first country in the world to implement countrywide triple-drug MDA. This paper aims to describe Samoa’s experience with program coverage and adverse events (AEs) in the first round of triple-drug MDA. We conducted a large cross-sectional community survey to assess MDA awareness, reach, compliance, coverage and AEs in September/October 2018, 7–11 weeks after the first round of triple-drug MDA. In our sample of 4420 people aged ≥2 years (2.2% of the population), age-adjusted estimates indicated that 89.0% of the eligible population were offered MDA, 83.9% of the eligible population took MDA (program coverage), and 80.2% of the total population took MDA (epidemiological coverage). Overall, 83.8% (2986/3563) reported that they did not feel unwell at all after taking MDA. Mild AEs (feeling unwell but able to do normal everyday things) were reported by 13.3% (476/3563) and moderate or severe AEs (feeling unwell and being unable to do normal everyday activities such as going to work or school) by 2.9% (103/3563) of participants. This study following the 2018 triple-drug MDA in Samoa demonstrated a high reported program awareness and reach of 90.8% and 89.0%, respectively. Age-adjusted program coverage of 83.9% of the total population showed that MDA was well accepted and well tolerated by the community.

scholarly journals The Added Value of Water, Sanitation, and Hygiene Interventions to Mass Drug Administration for Reducing the Prevalence of Trachoma: A Systematic Review Examining

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Anyess Travers ◽  
Sheryl Strasser ◽  
Stephanie L. Palmer ◽  
Christine Stauber
Keyword(s):  
Systematic Review ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
Added Value ◽  
World Health ◽  
Sanitation And Hygiene ◽  
Pubmed Database ◽  
Health Organization ◽  
Hygiene Education ◽  
The Impact

Trachoma is the leading cause of infectious blindness worldwide. The SAFE strategy, the World Health Organization-recommended method to eliminate blinding trachoma, combines developments in water, sanitation, surgery, and antibiotic treatment. Current literature does not focus on the comprehensive effect these components have on one another. The present systematic review analyzes the added benefit of water, sanitation, and hygiene education interventions to preventive mass drug administration of azithromycin for trachoma. Trials were identified from the PubMed database using a series of search terms. Three studies met the complete criteria for inclusion. Though all studies found a significant change in reduction of active trachoma prevalence, the research is still too limited to suggest the impact of the “F” and “E” components on trachoma prevalence and ultimately its effects on blindness.

scholarly journals New Challenges in Malaria Elimination

2021 ◽  
Author(s):  
Susanta Kumar Ghosh ◽  
Chaitali Ghosh
Keyword(s):  
Malaria Elimination ◽  
New Technologies ◽  
Point Of Care ◽  
Artemisinin Resistance ◽  
Sub Saharan Africa ◽  
Chloroquine Resistance ◽  
World Health ◽  
Synthetic Pyrethroids ◽  
Sub Saharan ◽  
Health Organization

In recent years, efforts to eliminate malaria has gained a tremendous momentum, and many countries have achieved this goal — but it has faced many challenges. Recent COVID-19 pandemic has compounded the challenges due to cessation of many on-field operations. Accordingly, the World Health Organization (WHO) has advocated to all malaria-endemic countries to continue the malaria elimination operations following the renewed protocols. The recent reports of artemisinin resistance in Plasmodium falciparum followed by indication of chloroquine resistance in P. vivax, and reduced susceptibility of synthetic pyrethroids used in long lasting insecticide nets are some issues hindering the elimination efforts. Moreover, long distance night migration of vector mosquitoes in sub-Saharan Africa and invasion of Asian vector Anopheles stephensi in many countries including Africa and Southeast Asia have added to the problems. In addition, deletion of histidine rich protein 2 and 3 (Pfhrp2/3) genes in P. falciparum in many countries has opened new vistas to be addressed for point-of-care diagnosis of this parasite. It is needed to revisit the strategies adopted by those countries have made malaria elimination possible even in difficult situations. Strengthening surveillance and larval source management are the main strategies for successful elimination of malaria. New technologies like Aptamar, and artificial intelligence and machine learning would prove very useful in addressing many ongoing issues related to malaria elimination.

scholarly journals Potential use of antibodies to provide an earlier indication of lymphatic filariasis resurgence in post-mass drug administration surveillance, American Samoa

2021 ◽  
Author(s):  
Angela M. Cadavid Restrepo ◽  
Katherine Gass ◽  
Kimberly Y. Won ◽  
Meru Sheel ◽  
Keri Robinson ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Drug Administration ◽  
Mass Drug Administration ◽  
American Samoa ◽  
School Level ◽  
World Health ◽  
Chi Squared ◽  
Health Organization ◽  
Potential Use

AbstractObjectivesUnder the Global Programme to Eliminate Lymphatic Filariasis (LF), American Samoa conducted seven rounds of mass drug administration between 2000 and 2006. The territory passed transmission assessment surveys (TAS) in 2011 (TAS-1) and 2015 (TAS-2) based on World Health Organization guidelines. In 2016, the territory failed TAS-3, indicating resurgence. This study aims to determine if antibodies (Ab) may have provided a timelier indication of LF resurgence in American Samoa.MethodsWe examined school-level Ag and Ab status (presence/absence of Ag- and Ab- positive children) and prevalence of single and combined Ab responses to Wb123, Bm14, Bm33 Ags at each TAS. Pearson’s chi-squared tests and logistic regression were used to examine associations between school-level Ab prevalence in TAS-1 and TAS-2 and school-level Ag status in TAS-3.ResultsSchools with higher prevalence of Wb123 Ab in TAS-2 had higher odds of being Ag-positive in TAS-3 (odds ratio [OR] 24.5, 95% CI:1.2-512.7). Schools that were Ab-positive for WB123 plus Bm14, Bm33 or both Bm14 and Bm33 in TAS-2 had higher odds of being Ag-positive in TAS-3 (OR 16.0-24.5).ConclusionAnti-filarial Abs could provide earlier signals of resurgence and enable a timelier response. The promising role of Abs in post-MDA surveillance and decision making should be further investigated in other settings.

Optimising Strategies for Malaria Elimination: Primaquine, Mass Drug Administration and Artemisinin Resistance

2011 ◽  
Vol 63 (6) ◽  
pp. e77
Author(s):  
Richard Maude ◽  
Duong Socheat ◽  
Chea Nguon ◽  
Shunmay Yeung ◽  
Lisa White
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Malaria Elimination ◽  
Artemisinin Resistance

scholarly journals Modelling the ability of mass drug administration to interrupt soil-transmitted helminth transmission: Community-based deworming in Kenya as a case study

2021 ◽  
Vol 15 (8) ◽  
pp. e0009625
Author(s):  
Nyuk Sian Chong ◽  
Stacey R. Smith? ◽  
Marleen Werkman ◽  
Roy M. Anderson
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
Initial Conditions ◽  
Drug Efficacy ◽  
World Health ◽  
High Prevalence ◽  
Lower Drug ◽  
Health Organization ◽  
The Impact

The World Health Organization has recommended the application of mass drug administration (MDA) in treating high prevalence neglected tropical diseases such as soil-transmitted helminths (STHs), schistosomiasis, lymphatic filariasis, onchocerciasis and trachoma. MDA—which is safe, effective and inexpensive—has been widely applied to eliminate or interrupt the transmission of STHs in particular and has been offered to people in endemic regions without requiring individual diagnosis. We propose two mathematical models to investigate the impact of MDA on the mean number of worms in both treated and untreated human subpopulations. By varying the efficay of drugs, initial conditions of the models, coverage and frequency of MDA (both annual and biannual), we examine the dynamic behaviour of both models and the possibility of interruption of transmission. Both models predict that the interruption of transmission is possible if the drug efficacy is sufficiently high, but STH infection remains endemic if the drug efficacy is sufficiently low. In between these two critical values, the two models produce different predictions. By applying an additional round of biannual and annual MDA, we find that interruption of transmission is likely to happen in both cases with lower drug efficacy. In order to interrupt the transmission of STH or eliminate the infection efficiently and effectively, it is crucial to identify the appropriate efficacy of drug, coverage, frequency, timing and number of rounds of MDA.

scholarly journals Implementation of mass drug administration for neglected tropical diseases in Guinea during the COVID-19 pandemic

2021 ◽  
Vol 15 (9) ◽  
pp. e0009807
Author(s):  
Fatoumata Sakho ◽  
Christelly Flore Badila ◽  
Benoit Dembele ◽  
Aissatou Diaby ◽  
Abdoul Karim Camara ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Neglected Tropical Diseases ◽  
Risk Mitigation ◽  
World Health ◽  
Mitigation Measures ◽  
Tropical Diseases ◽  
First Case ◽  
Household Members ◽  
Health Organization

Background Guinea reported its first case of COVID-19 on March 12, 2020. Soon thereafter, a national state of emergency was declared, all land borders were closed, schools were shut down, and public gatherings were limited. Many health activities, including field-based activities targeting neglected tropical diseases (NTDs), were paused. The World Health Organization (WHO) issued updated guidance on the resumption of NTD field-based activities on July 27, 2020. In response, the Guinea Ministry of Health (MoH) and its partners planned and resumed mass drug administration (MDA) in mid-August to September 2020 in 19 health districts. Methodology/principal findings A risk-benefit assessment was conducted to identify potential risks associated with the MDA in the COVID-19 context. Following this assessment, a risk mitigation plan with barrier measures was developed to guide MDA implementation. These measures included COVID-19 testing for all national staff leaving Conakry, mask wearing, social distancing of two meters, and hand washing/sanitizing. A checklist was developed and used to monitor compliance to risk mitigation measures. Data on adherence to risk mitigation measures were collected electronically during the MDA. A total of 120 checklists, representing 120 community drug distributor (CDD) teams (two CDDs per team) and 120 households, were completed. Results indicated that washing or disinfecting hands was practiced by 68.3% of CDD teams, compared to 45.0% among households. Face masks to cover the mouth and nose were worn by 79.2% of CDD teams, while this was low among households (23.3%). In 87.5% of households, participants did not touch the dose pole and in 88.3% of CDD teams, CDDs did not touch the hands of the participants while giving the drugs. A large majority of CDD teams (94.2%) and household members (94.2%) were willing to participate in the MDA despite the pandemic. The epidemiological coverage was ≥65% for lymphatic filariasis, onchocerciasis and soil-transmitted helminths in 10 out of 19 HDs and ≥75% for schistosomiasis for school-aged children in 7 out of 11 HDs. Conclusions/significance Guinea was one of the first countries in Africa to resume MDA activities during the COVID-19 pandemic without causing an observed increase of transmission. The development of a risk mitigation plan and a method to monitor adherence to barrier measures was critical to this unprecedented effort. The rapid incorporation of COVID-19 barrier measures and their acceptance by CDDs and household members demonstrated both the adaptability of the National NTD Program to respond to emerging issues and the commitment of the MoH to implement NTD programs.

scholarly journals Reactive Case Detection (RACD) and foci investigation strategies in malaria control and elimination: a review

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Ruwanthi Perera ◽  
Amandhi Caldera ◽  
A. Rajitha Wickremasinghe
Keyword(s):  
Malaria Elimination ◽  
World Health ◽  
Case Detection ◽  
Reactive Case Detection ◽  
Target Populations ◽  
Online Databases ◽  
Health Organization ◽  
Criteria For Selection ◽  
Selection Of ◽  
Country Specific

Abstract Background Reactive case detection (RACD) and foci investigation are key strategies in malaria elimination and prevention of its re-establishment. They are a key part of surveillance that has been recommended by the World Health Organization (WHO) to be considered as a core intervention and as one of the three pillars of the Global Technical Strategy for Malaria 2016–2030. Methods A search using the key words “Reactive Case Detection”, “RACD”, “RCD” and “Malaria” was carried out in PubMed, Scopus, Taylor and Francis online databases for studies published until 31st July 2019. The inclusion criteria for selection of articles for review included (1) how RACD is implemented in each country; (2) challenges faced in RACD implementation; (3) suggestions on how the effectiveness of RACD process can be improved. Results 411 titles were identified, 41 full text articles were screened and 29 were found eligible for inclusion in the review. Published literature on RACD, and case and foci investigations has mostly assessed the process of the activity. Most studies have documented that the yield of positives in RACD has been highest in the index case’s household and the immediate neighbourhood of the index case. Microscopy and RDTs are the common tests used in RACD. The guidelines for case and foci investigation, and RACD and PACD, are not universally adopted and are country-specific. Some of the limitations and challenges identified include lack of proper guidelines, logistic issues and problems with public compliance. Conclusions Although there is no documented evidence that RACD is useful in malaria elimination settings, most authors have opined that RACD is necessary for malaria elimination. Lack of knowledge in the target populations, a target radius and how to carry out the RACD process is a major challenge in the decision-making process.

scholarly journals Predictive Value of Ov16 Antibody Prevalence in Different Subpopulations for Elimination of African Onchocerciasis

2019 ◽  
Vol 188 (9) ◽  
pp. 1723-1732 ◽  
Author(s):  
Luc E Coffeng ◽  
Wilma A Stolk ◽  
Allison Golden ◽  
Tala de los Santos ◽  
Gonzalo J Domingo ◽  
...  
Keyword(s):  
Drug Administration ◽  
Mass Drug Administration ◽  
Predictive Value ◽  
Age Groups ◽  
World Health ◽  
Age Group ◽  
Threshold Values ◽  
Antibody Prevalence ◽  
Endemic Areas ◽  
Health Organization

Abstract The World Health Organization currently recommends assessing elimination of onchocerciasis by testing whether Ov16 antibody prevalence in children aged 0–9 years is below 0.1%. However, the certainty of evidence for this recommendation is considered to be low. We used the established ONCHOSIM model to investigate the predictive value of different Ov16-antibody prevalence thresholds in various age groups for elimination of onchocerciasis in a variety of endemic settings and for various mass drug administration scenarios. According to our simulations, the predictive value of Ov16 antibody prevalence for elimination depends highly on the precontrol epidemiologic situation, history of mass drug administration, the age group that is sampled, and the chosen Ov16-antibody prevalence threshold. The Ov16 antibody prevalence in children aged 5–14 years performs best in predicting elimination. Appropriate threshold values for this age group start at 2.0% for very highly endemic areas; for lower-endemic areas, even higher threshold values are safe to use. Guidelines can be improved by sampling school-aged children, which also is operationally more feasible than targeting children under age 10 years. The use of higher threshold values allows sampling of substantially fewer children. Further improvement can be achieved by taking a differentiated sampling approach based on precontrol endemicity.

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