{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T19:16:47Z","timestamp":1793128607651,"version":"4.5.0"},"reference-count":38,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4_Suppl","license":[{"start":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T00:00:00Z","timestamp":1712016000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,2]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Malaria remains a significant cause of morbidity and mortality, even in low-transmission settings. With the advent of longer acting, more effective, and well-tolerated antimalarials, there is renewed interest in the efficacy of mass drug administration (MDA) to accelerate to elimination. We conducted a systematic review and meta-analysis to assess the efficacy of MDA to reduce the incidence and prevalence of <jats:italic>Plasmodium falciparum<\/jats:italic> (<jats:italic>Pf<\/jats:italic>) and <jats:italic>Plasmodium vivax<\/jats:italic> (<jats:italic>Pv<\/jats:italic>) infection. From 1,044 articles screened, 14 articles, including 10 randomized controlled trials (RCTs), were identified. Five included data on <jats:italic>Pf<\/jats:italic> only; five included <jats:italic>Pf<\/jats:italic> and <jats:italic>Pv<\/jats:italic>. Two of the <jats:italic>Pf<\/jats:italic> studies were conducted in areas of high\u2013moderate transmission, the remainder were in areas of low\u2013very low transmission. In higher transmission areas, MDA reduced incidence of <jats:italic>Pf<\/jats:italic> parasitemia (rate ratio = 0.61, 95% CI: 0.40\u20130.92; moderate certainty) 1 to 3\u2009months after drug administration; no significant effect of MDA on <jats:italic>Pf<\/jats:italic> parasitemia prevalence was detected 1 to 3\u2009months post-MDA (risk ratio [RR] = 1.76, 95% CI: 0.58\u20135.36; low certainty). In lower transmission settings, both incidence and prevalence of <jats:italic>Pf<\/jats:italic> parasitemia were reduced 1 to 3\u2009months post-MDA (rate ratio = 0.37, 95% CI: 0.21\u20130.66; RR = 0.25, 95% CI: 0.15\u20130.41, respectively). <jats:italic>Pv<\/jats:italic> prevalence was reduced 1 to 3\u2009months post-MDA (RR = 0.15, 95% CI: 0.10\u20130.24); there were no RCTs providing data on incidence of <jats:italic>Pv<\/jats:italic>. There was no significant effect of MDA at later time points. MDA may have short-term benefits; however, there was no evidence for longer term impact, although none of the trials assessed prolonged interventions.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0766","type":"journal-article","created":{"date-parts":[[2023,12,20]],"date-time":"2023-12-20T20:59:11Z","timestamp":1703105951000},"page":"17-29","source":"Crossref","is-referenced-by-count":19,"title":["Mass Drug Administration to Reduce Malaria Transmission: A Systematic Review and Meta-Analysis"],"prefix":"10.4269","volume":"110","author":[{"given":"Zachary D.","family":"Schneider","sequence":"first","affiliation":[{"name":"Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica P.","family":"Shah","sequence":"additional","affiliation":[{"name":"Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa C.","family":"Boily","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra L.","family":"Busbee","sequence":"additional","affiliation":[{"name":"Rollins School of Public Health, Emory University, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimee","family":"Hwang","sequence":"additional","affiliation":[{"name":"U.S. President\u2019s Malaria Initiative, Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim A.","family":"Lindblade","sequence":"additional","affiliation":[{"name":"Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"},{"name":"Global Malaria Programme, World Health Organization, Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie R.","family":"Gutman","sequence":"additional","affiliation":[{"name":"Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"WHO Malaria Terminology.","year":"2016"},{"key":"b2","series-title":"Clin Microbiol Rev","first-page":"377","article-title":"Epidemiology and infectivity of Plasmodium falciparum and Plasmodium vivax gametocytes in relation to malaria control and elimination","volume":"24","author":"Bousema","year":"2011"},{"key":"b3","series-title":"Lancet Glob Health","first-page":"e680","article-title":"Role of mass drug administration in elimination of Plasmodium falciparum malaria: a consensus modelling study","volume":"5","author":"Brady","year":"2017"},{"key":"b4","series-title":"Consensus Modelling Evidence to Support the Design of Mass Drug Administration Programmes","year":"2015"},{"key":"b5","series-title":"Cochrane Database Syst Rev","first-page":"CD008846","article-title":"Mass drug administration for malaria","volume":"2013","author":"Poirot","year":"2013"},{"key":"b6","series-title":"Malar J","first-page":"281","article-title":"Mass drug administration can be a valuable addition to the malaria elimination toolbox","volume":"18","author":"Eisele","year":"2019"},{"key":"b7","series-title":"PLoS One","first-page":"e20179","article-title":"The potential contribution of mass treatment to the control of Plasmodium falciparum malaria","volume":"6","author":"Okell","year":"2011"},{"key":"b8","series-title":"Lancet","first-page":"1560","article-title":"Malaria eradication on islands","volume":"356","author":"Kaneko","year":"2000"},{"key":"b9","series-title":"Gaoxiong Yi Xue Ke Xue Za Zhi","first-page":"263","article-title":"Malaria eradication in Taiwan, 1952\u20131964 \u2013 some memorable facts","volume":"7","author":"Chen","year":"1991"},{"key":"b10","series-title":"Bull World Health Organ","first-page":"595","article-title":"MALARIA control and eradication in Taiwan: progress report, May 1952 50 June 1957","volume":"19","year":"1958"},{"key":"b11","series-title":"Malar J","first-page":"147","article-title":"Seven decades towards malaria elimination in Yunnan, China","volume":"20","author":"Li","year":"2021"},{"key":"b12","series-title":"Adv Parasitol","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/bs.apar.2022.04.001","article-title":"Mass drug administration in response to vivax malaria resurgence in Anhui Province of Huanghuai Plain, China","volume":"116","author":"Xu","year":"2022"},{"key":"b13","series-title":"The Role of Mass Drug Administration, Mass Screening and Treatment, and Focal Screening and Treatment for Malaria: Recommendations","year":"2015"},{"key":"b14","series-title":"Malaria Policy Advisory Committee Meeting Report","year":"2019"},{"key":"b15","series-title":"Am J Trop Med Hyg","first-page":"11","article-title":"Development of systematic reviews to inform WHO's recommendations for elimination and prevention of re-establishment of malaria: Methodology","volume":"110","author":"Tussell","year":"2024"},{"key":"b16","year":"1951"},{"key":"b17","series-title":"Annex VII: Indications and Dosages of Antimalarial Drugs in Pre-Eradication Programmes and in Malaria Eradication Programmes.","year":"1963"},{"key":"b18","series-title":"Am J Trop Med Hyg","first-page":"124","article-title":"Mass relapse prevention to reduce transmission of Plasmodium vivax \u2013 a systematic review","volume":"110","author":"Shah","year":"2024"},{"key":"b19","series-title":"A Framework for Malaria Elimination","year":"2017"},{"key":"b20","series-title":"J Clin Epidemiol","first-page":"401","article-title":"GRADE 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Rating the quality of evidence","volume":"64","author":"Balshem","year":"2011"},{"key":"b21","series-title":"Am J Trop Med Hyg","first-page":"7","article-title":"Impact of four rounds of mass drug administration with dihydroartemisinin-piperaquine implemented in Southern Province, Zambia","volume":"103","author":"Eisele","year":"2020"},{"key":"b22","series-title":"BMC Med","first-page":"215","article-title":"A cluster randomised controlled trial of two rounds of mass drug administration in Zanzibar, a malaria pre-elimination setting-high coverage and safety, but no significant impact on transmission","volume":"16","author":"Morris","year":"2018"},{"key":"b23","series-title":"Malar J","first-page":"247","article-title":"A cluster-randomized trial of mass drug administration with a gametocytocidal drug combination to interrupt malaria transmission in a low endemic area in Tanzania","volume":"10","author":"Shekalaghe","year":"2011"},{"key":"b24","series-title":"Trends Parasitol","first-page":"452","article-title":"Mass administrations of antimalarial drugs","volume":"19","author":"von Seidlein","year":"2003"},{"key":"b25","series-title":"Am J Trop Med Hyg","first-page":"725","article-title":"A longitudinal study of human malaria in the West African Savanna in the absence of control measures: relationships between different Plasmodium species, in particular P. falciparum and P. malariae","volume":"29","author":"Molineaux","year":"1980"},{"key":"b26","series-title":"Bull Soc Pathol Exot","first-page":"1012","article-title":"[The eradication of malaria and chemotherapy. Results of a trial of a trial of the combination: \u201c4-aminoquinoline\u201d\/\u201c8-aminoquinoline\u201d in the \u201cpilot zone\u201d of Bobo-Diculasso (Haute-Volta)]","volume":"54","author":"Schneider","year":"1961"},{"key":"b27","series-title":"Lancet Infect Dis","first-page":"1579","article-title":"Mass drug administration for the acceleration of malaria elimination in a region of Myanmar with artemisinin-resistant falciparum malaria: a cluster-randomised trial","volume":"21","author":"McLean","year":"2021"},{"key":"b28","series-title":"PLoS Med","first-page":"e1002745","article-title":"The impact of targeted malaria elimination with mass drug administrations on falciparum malaria in Southeast Asia: a cluster randomised trial","volume":"16","author":"von Seidlein","year":"2019"},{"key":"b29","series-title":"Bol Malariol Salud Ambient","first-page":"83","article-title":"Malaria antes y despu\u00e9s de la cura radical masiva en el Estado Sucre, Venezuela","volume":"48","author":"C\u00e1ceres","year":"2008"},{"key":"b30","series-title":"Bol Oficina Sanit Panam","first-page":"226","article-title":"Mass drug trial of pyrimethamine and primaquine for the eradication of malaria in Sambu, Republic of Panama","volume":"70","author":"Comer","year":"1971"},{"key":"b31","series-title":"Am J Trop Med Hyg","first-page":"433","article-title":"An attempt to eradicate malaria by the weekly administration of pyrimethamine in areas of out-of-doors transmission in Venezuela","volume":"8","author":"Gabaldon","year":"1959"},{"key":"b32","series-title":"Trans R Soc Trop Med Hyg","first-page":"547","article-title":"Mass treatment with pyrimethamine; a study of resistance and cross resistance resulting from a field trial in the hyperendemic malarious area of Makueni, Kenya. 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