ASTMH 2017, Antonio Quispe: “Reactive case detection with targeted mass drug administration: Interrupting malaria transmission and achieving elimination beyond intervention areas in northwestern Peru”

In collaboration with ASTMH, Image Audiovisuals, and session presenters, MESA brings you this webcast from the 66th ASTMH annual meeting in Baltimore, November 2017

Title: “Reactive case detection with targeted mass drug administration: Interrupting malaria transmission and achieving elimination beyond intervention areas in northwestern Peru”

Speaker: Antonio Quispe, Johns Hopkins Bloomberg School of Public Health

Session information: 

Symposium 0105: “Malaria: Mass Drug Administration and Reactive Case Detection for Malaria Elimination”

Tuesday, 7 November, 4:00 – 5:45 PM, Convention Center – Ballroom III (Level 400)

Abstract:

Reactive case detection (RCD) with targeted mass drug administration (tMDA) was previously found to be an effective strategy to support malaria elimination initiatives in Tumbes Peru, a region with a predominance of vivax malaria. We assessed the effect of RCD/tMDA on malaria incidence in intervention areas of Tumbes and the surrounding region of Piura. A pilot malaria elimination program based on RCD/tMDA was rolled out in the two most highly malaria-endemic districts (nine reporting units) in Tumbes from 2009-2010 and then scaled up to 11 additional districts (34 reporting units) from 2011-2014. Non-intervention areas in Piura were evaluated from 2011-2016. Malaria cases were passively detected, and followed-up within 24 hours together with household contacts (excluding elders, pregnant women, and chronically-ill subjects). The primary study endpoint was a temporospatial reduction in weekly parasite incidence (WPI = total malaria cases per week/ 1,000 inhabitants) across all reporting units, analyzed by proximity to the intervention area’s reporting unit. During the study period (2009-2014) we analyzed a total of 9102 autochthonous malaria cases. During the pilot program we estimated a mean reduction in WPI across Tumbes intervention areas of 99% (97−100) and 85% (77−94) at 12 and 24 months (m), respectively; and non-intervention areas of 34% (27−40) and 86% (76−93) at 12m and 24m, respectively. During the same period, we estimated a mean reduction in WPI at the near, mid and far range Piura districts of 63%, -73%, and -420% at 12m, and 91%, -126% and 91% at 24m, respectively. After scale up, we found a negative association between the mean WPI reduction and proximity to intervention area across the Piura districts, at both 24m (p=0.04) and 48m (p<0.01). During years 2015 and 2016, neither area in Tumbes nor in Piura has reported any autochthonous malaria cases. The RCD/tMDA strategy has shown to effectively interrupt malaria transmission in the Piura region and may support malaria elimination initiatives in other settings with a high predominance of vivax malaria.