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Conner RO, Dieye Y, Hainsworth M, Tall A, Cissé B, Faye F, Sy MD, Ba A, Sene D, Ba S, Doucouré E, Thiam T, Diop M, Schneider K, Cissé M, Ba M, Earle D, Guinot P, Steketee RW, Guinovart C. Mass testing and treatment for malaria followed by weekly fever screening, testing and treatment in Northern Senegal: feasibility, cost and impact. Malar J 2020; 19:252. [PMID: 32664939 PMCID: PMC7362450 DOI: 10.1186/s12936-020-03313-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 07/04/2020] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Population-wide interventions using malaria testing and treatment might decrease the reservoir of Plasmodium falciparum infection and accelerate towards elimination. Questions remain about their effectiveness and evidence from different transmission settings is needed.
Methods
A pilot quasi-experimental study to evaluate a package of population-wide test and treat interventions was conducted in six health facility catchment areas (HFCA) in the districts of Kanel, Linguère, and Ranérou (Senegal). Seven adjacent HFCAs were selected as comparison. Villages within the intervention HFCAs were stratified according to the 2013 incidences of passively detected malaria cases, and those with an incidence ≥ 15 cases/1000/year were targeted for a mass test and treat (MTAT) in September 2014. All households were visited, all consenting individuals were tested with a rapid diagnostic test (RDT), and, if positive, treated with dihydroartemisinin-piperaquine. This was followed by weekly screening, testing and treatment of fever cases (PECADOM++) until the end of the transmission season in January 2015. Villages with lower incidence received only PECADOM++ or case investigation. To evaluate the impact of the interventions over that transmission season, the incidence of passively detected, RDT-confirmed malaria cases was compared between the intervention and comparison groups with a difference-in-difference analysis using negative binomial regression with random effects on HFCA.
Results
During MTAT, 89% (2225/2503) of households were visited and 86% (18,992/22,170) of individuals were tested, for a combined 77% effective coverage. Among those tested, 291 (1.5%) were RDT positive (range 0–10.8 by village), of whom 82% were < 20 years old and 70% were afebrile. During the PECADOM++ 40,002 visits were conducted to find 2784 individuals reporting fever, with an RDT positivity of 6.5% (170/2612). The combination of interventions resulted in an estimated 38% larger decrease in malaria case incidence in the intervention compared to the comparison group (adjusted incidence risk ratio = 0.62, 95% CI 0.45–0.84, p = 0.002). The cost of the MTAT was $14.3 per person.
Conclusions
It was operationally feasible to conduct MTAT and PECADOM++ with high coverage, although PECADOM++ was not an efficient strategy to complement MTAT. The modest impact of the intervention package suggests a need for alternative or complementary strategies.
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Conner RO, Dieye Y, Hainsworth M, Tall A, Cissé B, Faye F, Sy MD, Ba A, Sene D, Ba S, Doucouré E, Thiam T, Diop M, Schneider K, Cissé M, Ba M, Scott CA, Kumar R, Asfaw E, Earle D, Guinot P, Steketee RW, Guinovart C. Correction to: Mass testing and treatment for malaria followed by weekly fever screening, testing and treatment in Northern Senegal: feasibility, cost and impact. Malar J 2020; 19:443. [PMID: 33256751 PMCID: PMC7706200 DOI: 10.1186/s12936-020-03484-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Ruben O Conner
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Yakou Dieye
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Michael Hainsworth
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Adama Tall
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Badara Cissé
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Farba Faye
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Mame Demba Sy
- Programme National de Lutte contre le Paludisme (PNLP), Ministère de la Santé et l'Action Sociale, Dakar, Senegal
| | - Amadou Ba
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Doudou Sene
- Programme National de Lutte contre le Paludisme (PNLP), Ministère de la Santé et l'Action Sociale, Dakar, Senegal
| | - Souleymane Ba
- Programme National de Lutte contre le Paludisme (PNLP), Ministère de la Santé et l'Action Sociale, Dakar, Senegal
| | - Elhadji Doucouré
- Programme National de Lutte contre le Paludisme (PNLP), Ministère de la Santé et l'Action Sociale, Dakar, Senegal
| | - Tidiane Thiam
- Programme National de Lutte contre le Paludisme (PNLP), Ministère de la Santé et l'Action Sociale, Dakar, Senegal
| | - Moussa Diop
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Kammerle Schneider
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Moustapha Cissé
- Programme National de Lutte contre le Paludisme (PNLP), Ministère de la Santé et l'Action Sociale, Dakar, Senegal
| | - Mady Ba
- Programme National de Lutte contre le Paludisme (PNLP), Ministère de la Santé et l'Action Sociale, Dakar, Senegal
| | - Callie A Scott
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Ritu Kumar
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Elias Asfaw
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Duncan Earle
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Philippe Guinot
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Richard W Steketee
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA
| | - Caterina Guinovart
- PATH Malaria Control and Elimination Partnership in Africa (MACEPA), 2201 Westlake Avenue, Suite 200, Seattle, WA, 98121, USA. .,Barcelona Institute for Global Health (ISGlobal), Hospital Clínic-Universitat de Barcelona, Rosselló 132, 08036, Barcelona, Spain.
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