1. Epidemiology and Global Health
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Determinants of MDA impact and designing MDAs towards malaria elimination

  1. Bo Gao
  2. Sompob Saralamba
  3. Yoel Lubell
  4. Lisa J White
  5. Arjen M Dondorp
  6. Ricardo Aguas  Is a corresponding author
  1. University of Oxford, United Kingdom
  2. Mahidol University, Thailand
Research Article
  • Cited 1
  • Views 687
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Cite this article as: eLife 2020;9:e51773 doi: 10.7554/eLife.51773

Abstract

Malaria remains at the forefront of scientific research and global political and funding agendas. Malaria models have consistently oversimplified how mass interventions are implemented. Here, we present an individual based, spatially explicit model of P. falciparum malaria transmission that includes all the programmatic implementation details of mass drug administration (MDA) campaigns. We uncover how the impact of MDA campaigns is determined by the interaction between implementation logistics, patterns of human mobility and how transmission risk is distributed over space. Our results indicate that malaria elimination is only realistically achievable in settings with very low prevalence and can be hindered by spatial heterogeneities in risk. In highly mobile populations, accelerating MDA implementation increases likelihood of elimination; if populations are more static, deploying less teams would be cost optimal. We conclude that mass drug interventions can be an invaluable tool towards malaria elimination in low endemicity areas, specifically when paired with effective vector control.

Article and author information

Author details

  1. Bo Gao

    Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  2. Sompob Saralamba

    Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
    Competing interests
    The authors declare that no competing interests exist.
  3. Yoel Lubell

    Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
    Competing interests
    The authors declare that no competing interests exist.
  4. Lisa J White

    Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
    Competing interests
    The authors declare that no competing interests exist.
  5. Arjen M Dondorp

    Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-5190-2395
  6. Ricardo Aguas

    Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom
    For correspondence
    ricardo@tropmedres.ac
    Competing interests
    The authors declare that no competing interests exist.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-6507-6597

Funding

Bill and Melinda Gates Foundation (OPP1110500)

  • Sompob Saralamba
  • Yoel Lubell
  • Lisa J White
  • Ricardo Aguas

Bill and Melinda Gates Foundation (OPP1193472)

  • Bo Gao
  • Ricardo Aguas

Wellcome

  • Yoel Lubell
  • Lisa J White
  • Arjen M Dondorp

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Reviewing Editor

  1. Eduardo Franco, McGill University, Canada

Publication history

  1. Received: September 10, 2019
  2. Accepted: April 12, 2020
  3. Accepted Manuscript published: April 15, 2020 (version 1)
  4. Version of Record published: April 27, 2020 (version 2)

Copyright

© 2020, Gao et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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