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. 2019 Dec 13;9(1):19060.
doi: 10.1038/s41598-019-55437-8.

Malaria resurgence after significant reduction by mass drug administration on Ngodhe Island, Kenya

Wataru Kagaya  1 , Jesse Gitaka  2 , Chim W Chan  1   3   4 , James Kongere  5 , Zulkarnain Md Idris  3   6 , Changsheng Deng  7 , Akira Kaneko  8   9   10
Affiliations

Malaria resurgence after significant reduction by mass drug administration on Ngodhe Island, Kenya

Wataru Kagaya et al. Sci Rep. .

Abstract

Although WHO recommends mass drug administration (MDA) for malaria elimination, further evidence is required for understanding the obstacles for the optimum implementation of MDA. Just before the long rain in 2016, two rounds of MDA with artemisinin/piperaquine (Artequick) and low-dose primaquine were conducted with a 35-day interval for the entire population of Ngodhe Island (~500 inhabitants) in Lake Victoria, Kenya, which is surrounded by areas with moderate and high transmission. With approximately 90% compliance, Plasmodium prevalence decreased from 3% to 0% by microscopy and from 10% to 2% by PCR. However, prevalence rebounded to 9% by PCR two months after conclusion of MDA. Besides the remained local transmission, parasite importation caused by human movement likely contributed to the resurgence. Analyses of 419 arrivals to Ngodhe between July 2016 and September 2017 revealed Plasmodium prevalence of 4.6% and 16.0% by microscopy and PCR, respectively. Risk factors for infection among arrivals included age (0 to 5 and 11 to 15 years), and travelers from Siaya County, located to the north of Ngodhe Island. Parasite importation caused by human movement is one of major obstacles to sustain malaria elimination, suggesting the importance of cross-regional initiatives together with local vector control.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Map of the study site in the Lake Victoria basin. Ngodhe Island is approximately 1 km2 in size and 3 km from nearest island, Rusinga, which is connected to the mainland by a bridge. The map was created with DIVA-GIS, version 7.5.0, http://www.diva-gis.org/.
Figure 2
Figure 2
Malaria prevalence by microscopy and PCR after MDA. (a) Ngodhe Island, (b) Kibuogi Island. Each point corresponds day 0, 2, 7, 35, 42, 120, 180 in (a) and day 0, 35, 120, 180 in (b) in chronological order.
Figure 3
Figure 3
MDA and follow-up schedule.
See this image and copyright information in PMC

References

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