Mass testing and treatment for malaria in low transmission areas in Amhara Region, Ethiopia

Autor: Girma S. Guesses, Asnakew K. Yeshiwondim, Callie A. Scott, Adem Agmas, Duncan Earle, Richard W. Steketee, Asefaw Getachew, Asmamaw L. Ayenew, Belay Bezabih, Berhane H. Tesfay, Worku M. Workie, Belendia Serda, Melkamu T. Zeleke, Caterina Guinovart
Jazyk: angličtina
Předmět:
Male
Rural Population
Veterinary medicine
Plasmodium vivax
Psychological intervention
law.invention
0302 clinical medicine
law
Surveys and Questionnaires
030212 general & internal medicine
Malaria
Falciparum
Child
Aged
80 and over
Rapid diagnostic test
biology
Coinfection
Incidence (epidemiology)
Middle Aged
Artemisinins
Drug Combinations
Transmission (mechanics)
Infectious Diseases
Ethanolamines
Child
Preschool
Mosquito net
Female
Adult
Adolescent
030231 tropical medicine
Plasmodium falciparum
03 medical and health sciences
Antimalarials
Young Adult
Drug Therapy
Environmental health
parasitic diseases
medicine
Malaria
Vivax
Humans
Aged
Fluorenes
Mass test and treat
Research
Artemether
Lumefantrine Drug Combination
Infant
biology.organism_classification
medicine.disease
Malaria
Parasitology
Ethiopia
Zdroj: Malaria Journal
ISSN: 1475-2875
DOI: 10.1186/s12936-016-1333-3
Popis: Background In areas with ongoing malaria transmission, strategies to clear parasites from populations can reduce infection and transmission. The objective of this paper was to describe a malaria mass testing and treatment (MTAT) intervention implemented in six kebeles (villages) in Amhara Region, Ethiopia, at the beginning of the 2014 transmission season. Methods Intervention kebeles were selected based on incidence of passively detected Plasmodium falciparum and mixed (P. falciparum and P. vivax) malaria cases during the 2013 malaria transmission season. All households in intervention kebeles were targeted; consenting residents received a rapid diagnostic test (RDT) and RDT-positive individuals received artemether-lumefantrine for P. falciparum/mixed infections or chloroquine for P. vivax. Data were collected on MTAT participation, sociodemographic characteristics, malaria risk factors, and RDT positivity. Results Of 9162 households targeted, 7974 (87.0 %) participated in the MTAT. Among the 35,389 residents of these households, 30,712 (86.8 %) received an RDT. RDT-positivity was 1.4 % (0.3 % P. vivax, 0.7 % P. falciparum, 0.3 % mixed), ranging from 0.3 to 5.1 % by kebele; 39.4 % of RDT-positive individuals were febrile, 28.5 % resided in the same household with another RDT-positive individual, 23.0 % were not protected by vector control interventions [mosquito net or indoor residual spray (IRS)], and 7.1 % had travel history. For individuals under 10 years of age, the odds of being RDT-positive was significantly higher for those with fever, recent use of anti-malarial drugs or residing in the same household with another RDT-positive individual; 59.0 % of RDT-positive individuals had at least one of these risk factors. For individuals 10 years of age and older, the odds of being RDT positive was significantly higher for those with reported travel, fever, recent use of anti-malarial drugs, no use of vector control, and those residing in the same household as another RDT-positive individual; 71.2 % of RDT-positive individuals had at least one of these risk factors. Conclusions In the Ethiopia setting, an MTAT intervention is operationally feasible and can be conducted with high coverage. RDT-positivity is low and varies widely by kebele. While several risk factors are significantly associated with RDT-positivity, there are still many RDT-positive individuals who do not have any of these risk factors. Strategies that target populations for testing and treatment based on these risk factors alone are likely to leave many infections undetected. Electronic supplementary material The online version of this article (doi:10.1186/s12936-016-1333-3) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
Externí odkaz: