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Guidelines for the treatment of malaria – 2 edition

Consistent with this concept, in an extensive analysis of 19 MDA projects carried out
19
over the period 1932–1999, only one study was shown to result in durably reduced
transmission. In that particular 1991 study on Aneityum Island, Vanuatu, MDA took
place over a 9-week period prior to the rainy season in a population that was relatively
small (718 people), well defined (the entire population of a remote island in the Pacific
Ocean with minimal contact with the outside world), and well controlled (resulting in
88.3% compliance). Monthly SP treatment and weekly CQ prophylaxis and weekly single
dose PQ were given as part of a package of interventions, including intensive health
education, a vector control programme based on full coverage ITN and larvivorous fish,
and a community microscopy-based surveillance system to prevent reintroduction and
checking all fever cases and screening all arrivals on the island. In this small and well-
defined study with a 9-year intense follow up, P. falciparum had disappeared by week
five; P. vivax transmission continued for another five years until 1996.
20

19 von Seidlein L, Greenwood BM. Mass administration of antimalarial drugs. Trends in Parasitology, 2003, 19:790–796.
20 Kaneko A et al. Malaria eradication on islands. Lancet, 2000, 356:1560–1564.
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