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

Malaria Journal

Research

Belay Bezabih¹  Caterina Guinovart²  Callie A. Scott²  Richard W. Steketee²  Adem Agmas³  Worku M. Workie³  Asefaw Getachew³  Asnakew K. Yeshiwondim³  Melkamu T. Zeleke³  Girma S. Guesses³  Berhane H. Tesfay³  Asmamaw L. Ayenew³  Belendia Serda³  Duncan Earle⁴ 

[1] Amhara National Regional State Health Bureau, P.O. Box 495, Bahir Dar, Ethiopia;PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, 98121, Seattle, WA, USA;PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Getu Commercial Center, PO Box 493, Rear Side, 1st–4th Floors, 1110, Addis Ababa, Ethiopia;PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Stand #16806, Trinity Park, Alick Nkhata Road, Mass Media Area, 10101, Lusaka, Zambia;

关键词: Malaria;    Mass test and treat;    Plasmodium falciparum;    Plasmodium vivax;    Ethiopia;   

DOI  :  10.1186/s12936-016-1333-3

 received in 2016-01-08, accepted in 2016-05-10,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundIn 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.MethodsIntervention 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.ResultsOf 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.ConclusionsIn 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.

【 授权许可】

CC BY   
© The Author(s) 2016