Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar 12;110(4_Suppl):54-64.
doi: 10.4269/ajtmh.23-0097. Print 2024 Apr 2.

Targeted Testing and Treatment To Reduce Human Malaria Transmission in High-Risk Populations: A Systematic Review

Beena Bhamani  1 , Elisabet Martí Coma-Cros  1 , Maria Tusell  1 , Vita Mithi  2   3   4 , Elisa Serra-Casas  1 , Nana Aba Williams  1 , Kim A Lindblade  5 , Koya C Allen  1
Affiliations

Targeted Testing and Treatment To Reduce Human Malaria Transmission in High-Risk Populations: A Systematic Review

Beena Bhamani et al. Am J Trop Med Hyg. .

Abstract

As countries approach elimination of malaria, groups with increased exposure to malaria vectors or poor access to health services may serve as important human reservoirs of infection that help maintain transmission in the community. Parasitological testing and treatment targeted to these groups may reduce malaria transmission overall. This systematic review assessed the effectiveness of targeted testing and treatment (TTaT) to reduce malaria transmission, the contextual factors, and the results of modeling studies that estimated the intervention's potential impact. Bibliographic searches were conducted in March 2021 and updated in April 2022, and a total of 1,210 articles were identified. Three studies were included for outcome data: one factorial cluster randomized controlled trial (cRCT) in Kenya (5,233 participants), one cRCT in Ghana (3,046 participants), and one controlled before-and-after cohort study in schoolchildren in Malawi (786 participants). Nine reports were included for contextual factors, and two were included for mathematical modeling. Data on outcomes from the three studies suggested that at the community level, TTaT would result in little to no difference in the incidence of malaria infection (measured via active surveillance), adverse events, and severe AEs. In contrast, the effects of TTaT on prevalence (malaria parasitemia) among those targeted by the intervention were found to include a short-term impact on reducing transmission but little to no impact on transmission for extended periods. Future iterations of this review should ensure consideration for populations proven to host the vast majority of the reservoir of infection in lower-transmission settings to determine the effectiveness of the intervention.

PubMed Disclaimer

Conflict of interest statement

Disclosures: This systematic review was originally undertaken as a part of the guideline development process for the Global Malaria Programme, WHO Headquarters, Geneva, Switzerland. The WHO Guideline Development Group provided expert advice in the formation of the review methodology and evidence to decision process for interpretation and recommendations.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram.
Figure 2.
Figure 2.
Relative effects of targeted testing and treatment (TTaT) intervention compared with no TTaT intervention on severe adverse events.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Sandfort M. et al., 2020. Forest malaria in Cambodia: the occupational and spatial clustering of Plasmodium vivax and Plasmodium falciparum infection risk in a cross-sectional survey in Mondulkiri province, Cambodia. Malar J 19: 413. - PMC - PubMed
    1. Stresman G, Whittaker C, Slater HC, Bousema T, Cook J, 2020. Quantifying Plasmodium falciparum infections clustering within households to inform household-based intervention strategies for malaria control programs: an observational study and meta-analysis from 41 malaria-endemic countries. PLoS Med 17: e1003370. - PMC - PubMed
    1. World Health Organization , 2022. WHO Guidelines for Malaria. Available at: https://www.who.int/publications/i/item/guidelines-for-malaria. Accessed June 3, 2022.
    1. Allen K, Tusell M, Marti-Coma Cros E, Whitfield K, Serra E, Rabinovich R, 2021. Targeted Test and Treat (TTaT) for Reduction of Human Malaria Transmission in High-Risk Populations: A Protocol for Systematic Review. Available at: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=232451. Accessed June 13, 2022.
    1. Tusell M. et al., 2023. Development of systematic reviews to inform WHO’s recommendations for elimination and prevention of re-establishment of malaria: methodology. Am J Trop Med Hyg doi: 10.4269/ajtmh.22-0740. - DOI - PMC - PubMed

Publication types