Okell, Lucy C., Griffin, Jamie T., Kleinschmidt, Immo, Hollingsworth, T. Déirdre, Churcher, Thomas S., White, Michael J., Bousema, Teun, Drakeley, Chris J. and Ghani, Azra C. (2011) The potential contribution of mass treatment to the control of plasmodium falciparum malaria. PLoS One, Volume 6 (Number 5). Article no. e20179. doi:10.1371/journal.pone.0020179 ISSN 1932-6203.

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Abstract

Mass treatment as a means to reducing P. falciparum malaria transmission was used during the first global malaria eradication campaign and is increasingly being considered for current control programmes. We used a previously developed mathematical transmission model to explore both the short and long-term impact of possible mass treatment strategies in different scenarios of endemic transmission. Mass treatment is predicted to provide a longer-term benefit in areas with lower malaria transmission, with reduced transmission levels for at least 2 years after mass treatment is ended in a scenario where the baseline slide-prevalence is 5%, compared to less than one year in a scenario with baseline slide-prevalence at 50%. However, repeated annual mass treatment at 80% coverage could achieve around 25% reduction in infectious bites in moderate-to-high transmission settings if sustained. Using vector control could reduce transmission to levels at which mass treatment has a longer-term impact. In a limited number of settings (which have isolated transmission in small populations of 1000–10,000 with low-to-medium levels of baseline transmission) we find that five closely spaced rounds of mass treatment combined with vector control could make at least temporary elimination a feasible goal. We also estimate the effects of using gametocytocidal treatments such as primaquine and of restricting treatment to parasite-positive individuals. In conclusion, mass treatment needs to be repeated or combined with other interventions for long-term impact in many endemic settings. The benefits of mass treatment need to be carefully weighed against the risks of increasing drug selection pressure.

Item Type:	Journal Article
Subjects:	Q Science > QR Microbiology > QR180 Immunology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) Faculty of Science, Engineering and Medicine > Science > Mathematics
Library of Congress Subject Headings (LCSH):	Malaria -- Immunological aspects, Health planning, Malaria -- Vaccination, Malaria -- Treatment
Journal or Publication Title:	PLoS One
Publisher:	Public Library of Science
ISSN:	1932-6203
Official Date:	2011
Dates:	Date Event 2011 Published
Volume:	Volume 6
Number:	Number 5
Page Range:	Article no. e20179
DOI:	10.1371/journal.pone.0020179
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	23 December 2015
Date of first compliant Open Access:	23 December 2015
Funder:	Bill & Melinda Gates Foundation, Medical Research Council (Great Britain) (MRC), Seventh Framework Programme (European Commission) (FP7), Imperial College, London, Wellcome Trust (London, England)
Grant number:	HEALTH-F3-2008-223736 (FP7)

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