Review of mass drug administration for malaria and its operational challenges.

Gretchen Newby; Jimee Hwang; Kadiatou Koita; Ingrid Chen; Brian Greenwood ORCID logo; Lorenz von Seidlein; G Dennis Shanks; Laurence Slutsker; S Patrick Kachur; Jennifer Wegbreit; +3 more... Matthew M Ippolito; Eugenie Poirot; Roly Gosling ORCID logo; (2015) Review of mass drug administration for malaria and its operational challenges. The American journal of tropical medicine and hygiene, 93 (1). pp. 125-134. ISSN 0002-9637 DOI: 10.4269/ajtmh.14-0254
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Mass drug administration (MDA) was a component of many malaria programs during the eradication era, but later was seldomly deployed due to concerns regarding efficacy and feasibility and fear of accelerating drug resistance. Recently, however, there has been renewed interest in the role of MDA as an elimination tool. Following a 2013 Cochrane Review that focused on the quantitative effects of malaria MDA, we have conducted a systematic, qualitative review of published, unpublished, and gray literature documenting past MDA experiences. We have also consulted with field experts, using their historical experience to provide an informed, contextual perspective on the role of MDA in malaria elimination. Substantial knowledge gaps remain and more research is necessary, particularly on optimal target population size, methods to improve coverage, and primaquine safety. Despite these gaps, MDA has been used successfully to control and eliminate Plasmodium falciparum and P. vivax malaria in the past, and should be considered as part of a comprehensive malaria elimination strategy in specific settings.


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