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Meta-Analysis
. 2023 Sep 3;22(1):254.
doi: 10.1186/s12936-023-04670-8.

Testing and treatment for malaria elimination: a systematic review

Gretchen Newby  1 , Chris Cotter  1   2 , Michelle E Roh  1   3 , Kelly Harvard  1 , Adam Bennett  1   3   4 , Jimee Hwang  5 , Nakul Chitnis  6   7 , Sydney Fine  1 , Gillian Stresman  8   9 , Ingrid Chen  1   3 , Roly Gosling  1   3   10 , Michelle S Hsiang  11   12   13
Affiliations
Meta-Analysis

Testing and treatment for malaria elimination: a systematic review

Gretchen Newby et al. Malar J. .

Erratum in

Abstract

Background: Global interest in malaria elimination has prompted research on active test and treat (TaT) strategies.

Methods: A systematic review and meta-analysis were conducted to assess the effectiveness of TaT strategies to reduce malaria transmission.

Results: A total of 72 empirical research and 24 modelling studies were identified, mainly focused on proactive mass TaT (MTaT) and reactive case detection (RACD) in higher and lower transmission settings, respectively. Ten intervention studies compared MTaT to no MTaT and the evidence for impact on malaria incidence was weak. No intervention studies compared RACD to no RACD. Compared to passive case detection (PCD) alone, PCD + RACD using standard diagnostics increased infection detection 52.7% and 11.3% in low and very low transmission settings, respectively. Using molecular methods increased this detection of infections by 1.4- and 1.1-fold, respectively.

Conclusion: Results suggest MTaT is not effective for reducing transmission. By increasing case detection, surveillance data provided by RACD may indirectly reduce transmission by informing coordinated responses of intervention targeting.

Keywords: Active case detection; Malaria; Malaria elimination; Plasmodium falciparum; Proactive; Reactive; Screen and treat; Test and treat.

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Conflict of interest statement

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

All authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Literature search results. *Eight of the 87 papers included had results from more than one transmission setting, location, or TaT approach and these results were analysed individually; thus, the total number of studies analysed was 96
Fig. 2
Fig. 2
Empiric studies by: A Transmission setting, B Predominant or targeted Plasmodium species, C Region, and D Diagnostic test used. Standard testing refers to microscopy and/or rapid diagnostic testing (RDT). + Molecular testing refers to standard testing with the addition of molecular testing for surveillance but not to inform treatment. + Molecular testing informing treatment refers to standard testing with the addition of molecular testing for both surveillance and to inform treatment
Fig. 3
Fig. 3
Meta-analysis of intervention studies evaluating mass test and treat (MTaT) versus no MTaT
Fig. 4
Fig. 4
Relative difference in number of cases by RACD using RDT/ microscopy + passive case detection (PCD) versus PCD alone. Summary estimates are reported by transmission strata and generated using a random effects model. Relative Ratio only takes into consideration PCD cases which lead to RACD, which, in most studies, were all PCD activities. This measure may be lower than if PCD activities that did not lead to RACD were also included, such as in Larsen et al. where PCD leading to RACD was reported as 1848, whereas the total number of PCD identified cases was 53,463
Fig. 5
Fig. 5
Relative difference in number of cases found by RACD using LAMP/PCR + PCD versus RACD using RDT/microscopy + PCD. Only includes studies where all reactive case detection (RACD) individuals were tested by both LAMP/PCR and RDT/microscopy. Summary estimates are reported by transmission strata and generated using a random effects model
See this image and copyright information in PMC

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