@article{fdi:010075280,
  title = {{T}he impact of targeted malaria elimination with mass drug administrations on falciparum malaria in {S}outheast {A}sia : a cluster randomised trial},
  author = {{V}on {S}eidlein, {L}. and {P}eto, {T}. {J}. and {L}andier, {J}ordi and {N}guyen, {T}. {N}. and {T}ripura, {R}. and {P}hommasone, {K}. and {P}ongvongsa, {T}. and {L}win, {K}. {M}. and {K}eereecharoen, {L}. and {K}ajeechiwa, {L}. and {T}hwin, {M}. {M}. and {P}arker, {D}. {M}. and {W}iladphaingern, {J}. and {N}osten, {S}. and {P}roux, {S}. and {C}orbel, {V}incent and {N}guyen, {T}. {V}. and {T}ruong, {L}. {P}. {N}. and {S}on, {D}. {H}. and {P}ham, {N}. {H}. {T}. and {T}uyen, {N}. {T}. {K}. and {T}ien, {N}. {T}. and {D}ong, {L}. {T}. and {H}ue, {D}. {V}. and {Q}uang, {H}. {H}. and {N}guon, {C}. and {D}avoeung, {C}. and {R}ekol, {H}. and {A}dhikari, {B}. and {H}enriques, {G}. and {P}hongmany, {P}. and {S}uangkanarat, {P}. and {J}eeyapant, {A}. and {V}ihokhern, {B}. and van der {P}luijm, {R}. {W}. and {L}ubell, {Y}. and {W}hite, {L}. {J}. and {A}guas, {R}. and {P}romnarate, {C}. and {S}irithiranont, {P}. and {M}alleret, {B}. and {R}enia, {L}. and {O}nsjo, {C}. and {C}han, {X}. {H}. and {C}halk, {J}. and {M}iotto, {O}. and {P}atumrat, {K}. and {C}hotivanich, {K}. and {H}anboonkunupakarn, {B}. and {J}ittmala, {P}. and {K}aehler, {N}. and {C}heah, {P}. {Y}. and {P}ell, {C}. and {D}horda, {M}. and {I}mwong, {M}. and {S}nounou, {G}. and {M}ukaka, {M}. and {P}eerawaranun, {P}. and {L}ee, {S}. {J}. and {S}impson, {J}. {A}. and {P}ukrittayakamee, {S}. and {S}inghasivanon, {P}. and {G}robusch, {M}. {P}. and {C}obelens, {F}. and {S}mithuis, {F}. and {N}ewton, {P}. {N}. and {T}hwaites, {G}. {E}. and {D}ay, {N}. {P}. {J}. and {M}ayxay, {M}. and {H}ien, {T}. {T}. and {N}osten, {F}. {H}. and {D}ondorp, {A}. {M}. and {W}hite, {N}. {J}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {T}he emergence and spread of multidrug-resistant {P}lasmodium falciparum in the {G}reater {M}ekong {S}ubregion ({GMS}) threatens global malaria elimination efforts. {M}ass drug administration ({MDA}), the presumptive antimalarial treatment of an entire population to clear the subclinical parasite reservoir, is a strategy to accelerate malaria elimination. {W}e report a cluster randomised trial to assess the effectiveness of dihydroartemisinin-piperaquine ({DP}) {MDA} in reducing falciparum malaria incidence and prevalence in 16 remote village populations in {M}yanmar, {V}ietnam, {C}ambodia, and the {L}ao {P}eople's {D}emocratic {R}epublic, where artemisinin resistance is prevalent. {M}ethods and findings {A}fter establishing vector control and community-based case management and following intensive community engagement, we used restricted randomisation within village pairs to select 8 villages to receive early {DP} {MDA} and 8 villages as controls for 12 months, after which the control villages received deferred {DP} {MDA}. {T}he {MDA} comprised 3 monthly rounds of 3 daily doses of {DP} and, except in {C}ambodia, a single low dose of primaquine. {W}e conducted exhaustive cross-sectional surveys of the entire population of each village at quarterly intervals using ultrasensitive quantitative {PCR} to detect {P}lasmodium infections. {T}he study was conducted between {M}ay 2013 and {J}uly 2017. {T}he investigators randomised 16 villages that had a total of 8,445 residents at the start of the study. {O}f these 8,445 residents, 4,135 (49%) residents living in 8 villages, plus an additional 288 newcomers to the villages, were randomised to receive early {MDA}; 3,790 out of the 4,423 (86%) participated in at least 1 {MDA} round, and 2,520 out of the 4,423 (57%) participated in all 3 rounds. {T}he primary outcome, {P}. falciparum prevalence by month 3 ({M}3), fell by 92% (from 5.1% [171/3,340] to 0.4% [12/2,828]) in early {MDA} villages and by 29% (from 7.2% [246/3,405] to 5.1% [155/3,057]) in control villages. {O}ver the following 9 months, the {P}. falciparum prevalence increased to 3.3% (96/2,881) in early {MDA} villages and to 6.1% (128/2,101) in control villages (adjusted incidence rate ratio 0.41 [95% {CI} 0.20 to 0.84]; p = 0.015). {I}ndividual protection was proportional to the number of completed {MDA} rounds. {O}f 221 participants with subclinical {P}. falciparum infections who participated in {MDA} and could be followed up, 207 (94%) cleared their infections, including 9 of 10 with artemisinin-and piperaquine- resistant infections. {T}he {DP} {MDA}s were well tolerated; 6 severe adverse events were detected during the follow-up period, but none was attributable to the intervention. {C}onclusions {A}dded to community-based basic malaria control measures, 3 monthly rounds of {DP} {MDA} reduced the incidence and prevalence of falciparum malaria over a 1-year period in areas affected by artemisinin resistance. {P}. falciparum infections returned during the follow-up period as the remaining infections spread and malaria was reintroduced from surrounding areas. {L}imitations of this study include a relatively small sample of villages, heterogeneity between villages, and mobility of villagers that may have limited the impact of the intervention. {T}hese results suggest that, if used as part of a comprehensive, well-organised, and well-resourced elimination programme, {DP} {MDA} can be a useful additional tool to accelerate malaria elimination.},
  keywords = {{MYANMAR} ; {VIET} {NAM} ; {CAMBODGE} ; {LAOS}},
  booktitle = {},
  journal = {{PL}o{S} {M}edicine},
  volume = {16},
  numero = {2},
  pages = {e1002745 [26 p.]},
  ISSN = {1549-1277},
  year = {2019},
  DOI = {10.1371/journal.pmed.1002745},
  URL = {https://www.documentation.ird.fr/hor/fdi:010075280},
}