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. 2021 Jul 12:8:617195.
doi: 10.3389/fmed.2021.617195. eCollection 2021.

Mass Drug Administration With Artemisinin-Piperaquine for the Elimination of Residual Foci of Malaria in São Tomé Island

Mingqiang Li  1 , Fei Tuo  1 , Ruixiang Tan  1 , Hongying Zhang  2 , Shaoqin Zheng  2 , Qi Wang  1 , Qin Xu  1 , Xinbing Yu  3 , Fangli Lu  3 , Zhibing Wu  4 , Jun Huang  5 , Herodes Sacramento Rampao  6 , Carlos Alberto Bandeira D'almeida  6 , Hong Yan  2 , Jianping Song  1 , Wenfeng Guo  1 , Changsheng Deng  1
Affiliations

Mass Drug Administration With Artemisinin-Piperaquine for the Elimination of Residual Foci of Malaria in São Tomé Island

Mingqiang Li et al. Front Med (Lausanne). .

Abstract

Background: Mass drug administration with artemisinin-piperaquine (AP-MDA) is being considered for elimination of residual foci of malaria in Democratic Republic of São Tomé and Principe. Methods: Three monthly rounds of AP-MDA were implemented from July to October 2019. Four zones were selected. A and B were selected as a study site and a control site, respectively. C and D were located within 1.5 and 1.5 km away from the study site, respectively. Parasite prevalence, malaria incidence, and the proportion of the Plasmodium falciparum malaria cases were evaluated. Results: After 3 monthly rounds of AP-MDA, the parasite prevalence and the gametocyte carriage rate of P. falciparum in zone A decreased from 28.29(‰) to 0 and 4.99(‰) to 0, respectively. Compared to zone B, the relative risk for the population with Plasmodium falciparum malaria in zone A was lower (RR = 0.458, 95% CI: 0.146-1.437). Malaria incidence fell from 290.49(‰) (the same period of the previous year) to 15.27(‰) (from the 29th week in 2019 to the 14th week in 2020), a decrease of 94.74% in zone A, and from 31.74 to 5.46(‰), a decline of 82.80% in zone B. Compared to the data of the same period the previous year, the cumulative number of P. falciparum malaria cases were lower, decreasing from 165 to 10 in zone A and from 17 to 4 in zone B. The proportion of the P. falciparum malaria cases on the total malaria cases of the country decreased of 90.16% in zone A and 71.34% in zone C. Conclusion: AP-MDA greatly curbed malaria transmission by reducing malaria incidence in the study site and simultaneously creating a knock-on effect of malaria control within 1.5 km of the study site and within the limited time interval of 38 weeks.

Keywords: P. falciparum; artemisinin-piperaquine; elimination; malaria foci; mass drug administration.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Geographical location of SãoTomé and Principe.
Figure 2
Figure 2
Distribution of AP-MDA village and its surroundings.
Figure 3
Figure 3
Geographical location of Liberdade and Budo Budo.
Figure 4
Figure 4
Process of study implementation.
See this image and copyright information in PMC

References

    1. World Health Organization [WHO] . World Malaria Report 2018 (2018). Geneva: WHO.
    1. World Health Organization [WHO] . World Malaria Report 2019 (2019). Geneva: WHO.
    1. Ministério da Saúde [MS] . PROTOCOLO PARA O MANEJO DE CASOS DE PALUDISMO. S. TOME E PRÍNCIPE: MS; (2018).
    1. World Health Organization [WHO] . Terminology of Malaria and of Malaria Eradication. Geneva: WHO; (1963).
    1. World Health Organization [WHO] . Guidelines on the Elimination of Residual Foci of Malaria Transmission. Geneva: WHO; (2007).

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