Evaluating the Effectiveness and Feasibility of Reactive Focal Mass Drug Administration vs. Reactive Case Detection as a Community Level Intervention in Response to a Passively Identified Index Malaria Case in Swaziland

Objectives

• Primary aim: To compare the impact of TPE (Targeted Parasite Elimination, fMDA) versus RACD (Reactive Case Detection) on malaria incidence.
• Secondary aims: 

Effectiveness:

1. To compare the impact of TPE versus RACD on seroprevalence.
2. To compare the impact of TPE versus RACD on prevalence of infection.
3. To compare the impact of TPE versus RACD on proportion of imported incident cases.
4. To compare the impact of TPE versus RACD on time to first post-intervention incident local case.
5. To compare the impact of TPE versus RACD on transmission potential as measured by relatedness of infections by microsatellite genotyping.

Feasibility:

1. To determine the feasibility of reaching 80% coverage for TPE versus RACD.
2. To evaluate the safety of TPE versus RACD.
3. To compare the acceptability of TPE versus RACD.
4. To compare the costs and cost-effectiveness of TPE versus RACD.
5. To measure the adherence to modified DOT regimen in the TPE arm.