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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Mass screening and treatment on the basis of results of a plasmodium falciparum-specific rapid diagnostic test did not reduce malaria incidence in zanzibar
Journal of Infectious Diseases, Volume 211, No. 9, Year 2015
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Description
Background. Seasonal increases in malaria continue in hot spots in Zanzibar. Mass screening and treatment (MSAT) may help reduce the reservoir of infection; however, it is unclear whether rapid diagnostic tests (RDTs) detect a sufficient proportion of low-density infections to influence subsequent transmission. Methods. Two rounds of MSAT using Plasmodium falciparum-specific RDT were conducted in 5 hot spots (population, 12 000) in Zanzibar in 2012. In parallel, blood samples were collected on filter paper for polymerase chain reaction (PCR) analyses. Data on confirmed malarial parasite infections from health facilities in intervention and hot spot control areas were monitored as proxy for malaria transmission. Results. Approximately 64% of the population (7859) were screened at least once. P. falciparum prevalence, as measured by RDT, was 0.2% (95% confidence interval [CI],. 1%-.3%) in both rounds, compared with PCR measured prevalences (for all species) of 2.5% (95% CI, 2.1%-2.9%) and 3.8% (95% CI, 3.2%-4.4%) in rounds 1 and 2, respectively. Two fifths (40%) of infections detected by PCR included non-falciparum species. Treatment of RDT-positive individuals (4% of the PCR-detected parasite carriers) did not reduce subsequent malaria incidence, compared with control areas. Conclusions. Highly sensitive point-of-care diagnostic tools for detection of all human malaria species are needed to make MSAT an effective strategy in settings where malaria elimination programs are in the pre-elimination phase. © 2014 The Author. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Cook, Jackie
Sweden, Stockholm
Karolinska Institutet
Xu, Weiping
Sweden, Stockholm
Karolinska Institutet
Msellem, Mwinyi I.
Unknown Affiliation
Gosling, Roland D.
United States, San Francisco
University of California, San Francisco
Al-Mafazy, Abdul Wahid H.
Unknown Affiliation
McElroy, Peter D.
United States, Atlanta
Centers for Disease Control and Prevention
Molteni, Fabrizio
Switzerland, Allschwil
Swiss Tropical and Public Health Institute Swiss Tph
Switzerland, Basel
Universitat Basel
Abass, Ali K.
Unknown Affiliation
Garimo, Issa A.
United States, Research Triangle Park
Rti International
Ramsan, Mahdi M.M.
United States, Research Triangle Park
Rti International
Ali, Abdullah Suleiman
Unknown Affiliation
Mårtensson, Andreas A.
Sweden, Stockholm
Karolinska Institutet
Sweden, Uppsala
Uppsala Universitet
Bjǒrkman, Anders B.
Sweden, Stockholm
Karolinska Institutet
Statistics
Citations: 82
Authors: 13
Affiliations: 7
Identifiers
Doi:
10.1093/infdis/jiu655
ISSN:
00221899
Research Areas
Infectious Diseases
Study Design
Randomised Control Trial
Cross Sectional Study
Cohort Study