Evaluating the Impact of Programmatic Mass Drug Administration for Malaria in Zambia Using Routine Incidence Data.

Autor:	Fraser M; PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Seattle, Washington, USA., Miller JM; PATH MACEPA, Lusaka, Zambia., Silumbe K; PATH MACEPA, Lusaka, Zambia., Hainsworth M; PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Seattle, Washington, USA., Mudenda M; National Malaria Elimination Centre, Zambia Ministry of Health, Lusaka, Zambia., Hamainza B; National Malaria Elimination Centre, Zambia Ministry of Health, Lusaka, Zambia., Moonga H; National Malaria Elimination Centre, Zambia Ministry of Health, Lusaka, Zambia., Chizema Kawesha E; National Malaria Elimination Centre, Zambia Ministry of Health, Lusaka, Zambia., Mercer LD; PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Seattle, Washington, USA., Bennett A; PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Seattle, Washington, USA.; University of California San Francisco, San Francisco, California, USA., Schneider K; PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Seattle, Washington, USA., Slater HC; PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Seattle, Washington, USA., Eisele TP; Center for Applied Malaria Research and Evaluation, Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA., Guinovart C; PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Seattle, Washington, USA.; Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	The Journal of infectious diseases [J Infect Dis] 2022 Apr 19; Vol. 225 (8), pp. 1415-1423.
DOI:	10.1093/infdis/jiaa434
Abstrakt:	Background: In 2016, the Zambian National Malaria Elimination Centre started programmatic mass drug administration (pMDA) campaigns with dihydroartemisinin-piperaquine as a malaria elimination tool in Southern Province. Two rounds were administered, 2 months apart (coverage 70% and 57%, respectively). We evaluated the impact of 1 year of pMDA on malaria incidence using routine data. Methods: We conducted an interrupted time series with comparison group analysis on monthly incidence data collected at the health facility catchment area (HFCA) level, with a negative binomial model using generalized estimating equations. Programmatic mass drug administration was conducted in HFCAs with greater than 50 cases/1000 people per year. Ten HFCAs with incidence rates marginally above this threshold (pMDA group) were compared with 20 HFCAs marginally below (comparison group). Results: The pMDA HFCAs saw a 46% greater decrease in incidence at the time of intervention than the comparison areas (incidence rate ratio = 0.536; confidence interval = 0.337-0.852); however, incidence increased toward the end of the season. No HFCAs saw a transmission interruption. Conclusions: Programmatic mass drug administration, implemented during 1 year with imperfect coverage in low transmission areas with suboptimal vector control coverage, significantly reduced incidence. However, elimination will require additional tools. Routine data are important resources for programmatic impact evaluations and should be considered for future analyses. (© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America.)
Databáze:	MEDLINE
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