Artemisinin combination therapy mass drug administration in a setting of low malaria endemicity: programmatic coverage and adherence during an observational study in Zanzibar
Abstract Background Mass drug administration (MDA) appears to be effective in reducing the risk of malaria parasitaemia. This study reports on programmatic coverage and compliance of MDA using artemisinin-based combination therapy (ACT) in four shehias (smallest administration unit) that had been id...
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ftdoajarticles:oai:doaj.org/article:87a3ebf9bf0f4541807eec8bfc54d5b2 2023-05-15T15:14:26+02:00 Artemisinin combination therapy mass drug administration in a setting of low malaria endemicity: programmatic coverage and adherence during an observational study in Zanzibar Abdullah S. Ali Narjis G. Thawer Bakar Khatib Haji H. Amier Joseph Shija Mwinyi Msellem Abdul-wahid Al-mafazy Issa A. Garimo Humphrey Mkali Mahdi M. Ramsan Jessica M. Kafuko Lynn A. Paxton Richard Reithinger Jeremiah M. Ngondi 2017-08-01T00:00:00Z https://doi.org/10.1186/s12936-017-1982-x https://doaj.org/article/87a3ebf9bf0f4541807eec8bfc54d5b2 EN eng BMC http://link.springer.com/article/10.1186/s12936-017-1982-x https://doaj.org/toc/1475-2875 doi:10.1186/s12936-017-1982-x 1475-2875 https://doaj.org/article/87a3ebf9bf0f4541807eec8bfc54d5b2 Malaria Journal, Vol 16, Iss 1, Pp 1-8 (2017) Mass drug administration Zanzibar Artemisinin-based combination therapy Hotspots Adherence Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 article 2017 ftdoajarticles https://doi.org/10.1186/s12936-017-1982-x 2022-12-31T11:08:44Z Abstract Background Mass drug administration (MDA) appears to be effective in reducing the risk of malaria parasitaemia. This study reports on programmatic coverage and compliance of MDA using artemisinin-based combination therapy (ACT) in four shehias (smallest administration unit) that had been identified as hotspots through Zanzibar’s malaria case notification surveillance system. Methods Mass drug administration was done in four shehias selected on the basis of: being an established malaria hot spot; having had mass screening and treatment (MSaT) 2–6 weeks previously; and exceeding the epidemic alert threshold of 5 cases within a week even after MSaT. Communities were sensitized and MDA was conducted using a house-to-house approach. All household members, except pregnant women and children aged less than 2 months, were provided with ACT medicine. Two weeks after the MDA campaign, a survey was undertaken to investigate completion of ACT doses. Results A total of 8816 [97.1% of eligible; 95% confidence interval (CI) 96.8–97.5] people received ACT. During post MDA surveys, 2009 people were interviewed: 90.2% reported having completed MDA doses; 1.9% started treatment but did not complete dosage; 4.7% did not take treatment; 2.0% were absent during MDA and 1.2% were ineligible (i.e. infants <2 months and pregnant women). Main reasons for failure to complete treatment were experience of side-effects and forgetting to take subsequent doses. Failure to take treatment was mainly due to fear of side-effects, reluctance due to lack of malaria symptoms and caregivers forgetting to give medication to children. Conclusion Mass drug administration for malaria was well accepted by communities at high risk of malaria in Zanzibar, with high participation and completion rates. Further work to investigate the potential of MDA in accelerating Zanzibar’s efforts towards malaria elimination should be pursued. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Malaria Journal 16 1 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
topic |
Mass drug administration Zanzibar Artemisinin-based combination therapy Hotspots Adherence Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
spellingShingle |
Mass drug administration Zanzibar Artemisinin-based combination therapy Hotspots Adherence Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 Abdullah S. Ali Narjis G. Thawer Bakar Khatib Haji H. Amier Joseph Shija Mwinyi Msellem Abdul-wahid Al-mafazy Issa A. Garimo Humphrey Mkali Mahdi M. Ramsan Jessica M. Kafuko Lynn A. Paxton Richard Reithinger Jeremiah M. Ngondi Artemisinin combination therapy mass drug administration in a setting of low malaria endemicity: programmatic coverage and adherence during an observational study in Zanzibar |
topic_facet |
Mass drug administration Zanzibar Artemisinin-based combination therapy Hotspots Adherence Arctic medicine. Tropical medicine RC955-962 Infectious and parasitic diseases RC109-216 |
description |
Abstract Background Mass drug administration (MDA) appears to be effective in reducing the risk of malaria parasitaemia. This study reports on programmatic coverage and compliance of MDA using artemisinin-based combination therapy (ACT) in four shehias (smallest administration unit) that had been identified as hotspots through Zanzibar’s malaria case notification surveillance system. Methods Mass drug administration was done in four shehias selected on the basis of: being an established malaria hot spot; having had mass screening and treatment (MSaT) 2–6 weeks previously; and exceeding the epidemic alert threshold of 5 cases within a week even after MSaT. Communities were sensitized and MDA was conducted using a house-to-house approach. All household members, except pregnant women and children aged less than 2 months, were provided with ACT medicine. Two weeks after the MDA campaign, a survey was undertaken to investigate completion of ACT doses. Results A total of 8816 [97.1% of eligible; 95% confidence interval (CI) 96.8–97.5] people received ACT. During post MDA surveys, 2009 people were interviewed: 90.2% reported having completed MDA doses; 1.9% started treatment but did not complete dosage; 4.7% did not take treatment; 2.0% were absent during MDA and 1.2% were ineligible (i.e. infants <2 months and pregnant women). Main reasons for failure to complete treatment were experience of side-effects and forgetting to take subsequent doses. Failure to take treatment was mainly due to fear of side-effects, reluctance due to lack of malaria symptoms and caregivers forgetting to give medication to children. Conclusion Mass drug administration for malaria was well accepted by communities at high risk of malaria in Zanzibar, with high participation and completion rates. Further work to investigate the potential of MDA in accelerating Zanzibar’s efforts towards malaria elimination should be pursued. |
format |
Article in Journal/Newspaper |
author |
Abdullah S. Ali Narjis G. Thawer Bakar Khatib Haji H. Amier Joseph Shija Mwinyi Msellem Abdul-wahid Al-mafazy Issa A. Garimo Humphrey Mkali Mahdi M. Ramsan Jessica M. Kafuko Lynn A. Paxton Richard Reithinger Jeremiah M. Ngondi |
author_facet |
Abdullah S. Ali Narjis G. Thawer Bakar Khatib Haji H. Amier Joseph Shija Mwinyi Msellem Abdul-wahid Al-mafazy Issa A. Garimo Humphrey Mkali Mahdi M. Ramsan Jessica M. Kafuko Lynn A. Paxton Richard Reithinger Jeremiah M. Ngondi |
author_sort |
Abdullah S. Ali |
title |
Artemisinin combination therapy mass drug administration in a setting of low malaria endemicity: programmatic coverage and adherence during an observational study in Zanzibar |
title_short |
Artemisinin combination therapy mass drug administration in a setting of low malaria endemicity: programmatic coverage and adherence during an observational study in Zanzibar |
title_full |
Artemisinin combination therapy mass drug administration in a setting of low malaria endemicity: programmatic coverage and adherence during an observational study in Zanzibar |
title_fullStr |
Artemisinin combination therapy mass drug administration in a setting of low malaria endemicity: programmatic coverage and adherence during an observational study in Zanzibar |
title_full_unstemmed |
Artemisinin combination therapy mass drug administration in a setting of low malaria endemicity: programmatic coverage and adherence during an observational study in Zanzibar |
title_sort |
artemisinin combination therapy mass drug administration in a setting of low malaria endemicity: programmatic coverage and adherence during an observational study in zanzibar |
publisher |
BMC |
publishDate |
2017 |
url |
https://doi.org/10.1186/s12936-017-1982-x https://doaj.org/article/87a3ebf9bf0f4541807eec8bfc54d5b2 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
Malaria Journal, Vol 16, Iss 1, Pp 1-8 (2017) |
op_relation |
http://link.springer.com/article/10.1186/s12936-017-1982-x https://doaj.org/toc/1475-2875 doi:10.1186/s12936-017-1982-x 1475-2875 https://doaj.org/article/87a3ebf9bf0f4541807eec8bfc54d5b2 |
op_doi |
https://doi.org/10.1186/s12936-017-1982-x |
container_title |
Malaria Journal |
container_volume |
16 |
container_issue |
1 |
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1766344882576687104 |