User login
Plasmodium vivax
Image by Mae Melvin
Mass drug administration (MDA) may have helped prevent a resurgence of malaria in Greece, according to research published in PLOS Neglected Tropical Diseases.
Greece was declared malaria-free in 1974 and remained that way until 2011, when there was an outbreak of Plasmodium vivax malaria in Southern Greece.
The outbreak was linked to the presence of agricultural workers from malaria-endemic regions in malaria-receptive areas.
There were 21 P vivax cases from arriving immigrants reported in the Southern agricultural area of Evrotas, along with 36 local cases.
So Greece implemented an integrated control program, with house visits established to screen immigrants from malaria-endemic countries.
Screening included a rapid diagnostic test for those reporting symptoms associated with malaria, along with blood sampling for smear and molecular testing for malaria. Directly observed treatment was provided for all patients who tested positive.
A vector control program was also implemented, with indoor residual spraying and long-lasting insecticide nets provided in areas close to mosquito breeding sites.
Despite these interventions, 20 more cases of malaria were reported in 2012.
Due to fears that the malaria parasite may be re-establishing itself in the area, Greece implemented an MDA program. It consisted of a single course of chloroquine and primaquine, which are the first-line recommended antimalarials for P vivax.
The program was implemented prior to the onset of peak adult mosquito activity, and field teams remained in situ continuing the active case detection until the end of the mosquito season. They recorded and managed adverse events daily.
The researchers identified an immigrant population of 1270 individuals, mostly from Pakistan and Afghanistan. The MDA covered 87% of this population.
No malaria cases were reported for 2013 and 2014, when the MDA was ongoing.
Of the treated individuals, 13% reported gastrointestinal symptoms from primaquine, while 36% reported non-severe side effects from chloroquine, including headaches, dizziness, and gastrointestinal complaints.
One potentially serious adverse event was recorded. It was a case of primaquine-induced hemolysis due to a false-normal G6PD level obtained prior to enrollment. The patient was hospitalized and recovered fully.
The researchers said that, in this case, the MDA program was a suitable and effective response for a small and geographically confined population over a short seasonal transition period. And the combination of 2 drugs minimized the risk of drug resistance.
The team added that, although an observational study of this nature cannot assess the extent to which the MDA program was responsible for eliminating malaria, it indicates that MDA should be considered and can be effective in local settings alongside other malaria control measures. 
Plasmodium vivax
Image by Mae Melvin
Mass drug administration (MDA) may have helped prevent a resurgence of malaria in Greece, according to research published in PLOS Neglected Tropical Diseases.
Greece was declared malaria-free in 1974 and remained that way until 2011, when there was an outbreak of Plasmodium vivax malaria in Southern Greece.
The outbreak was linked to the presence of agricultural workers from malaria-endemic regions in malaria-receptive areas.
There were 21 P vivax cases from arriving immigrants reported in the Southern agricultural area of Evrotas, along with 36 local cases.
So Greece implemented an integrated control program, with house visits established to screen immigrants from malaria-endemic countries.
Screening included a rapid diagnostic test for those reporting symptoms associated with malaria, along with blood sampling for smear and molecular testing for malaria. Directly observed treatment was provided for all patients who tested positive.
A vector control program was also implemented, with indoor residual spraying and long-lasting insecticide nets provided in areas close to mosquito breeding sites.
Despite these interventions, 20 more cases of malaria were reported in 2012.
Due to fears that the malaria parasite may be re-establishing itself in the area, Greece implemented an MDA program. It consisted of a single course of chloroquine and primaquine, which are the first-line recommended antimalarials for P vivax.
The program was implemented prior to the onset of peak adult mosquito activity, and field teams remained in situ continuing the active case detection until the end of the mosquito season. They recorded and managed adverse events daily.
The researchers identified an immigrant population of 1270 individuals, mostly from Pakistan and Afghanistan. The MDA covered 87% of this population.
No malaria cases were reported for 2013 and 2014, when the MDA was ongoing.
Of the treated individuals, 13% reported gastrointestinal symptoms from primaquine, while 36% reported non-severe side effects from chloroquine, including headaches, dizziness, and gastrointestinal complaints.
One potentially serious adverse event was recorded. It was a case of primaquine-induced hemolysis due to a false-normal G6PD level obtained prior to enrollment. The patient was hospitalized and recovered fully.
The researchers said that, in this case, the MDA program was a suitable and effective response for a small and geographically confined population over a short seasonal transition period. And the combination of 2 drugs minimized the risk of drug resistance.
The team added that, although an observational study of this nature cannot assess the extent to which the MDA program was responsible for eliminating malaria, it indicates that MDA should be considered and can be effective in local settings alongside other malaria control measures.
Plasmodium vivax
Image by Mae Melvin
Mass drug administration (MDA) may have helped prevent a resurgence of malaria in Greece, according to research published in PLOS Neglected Tropical Diseases.
Greece was declared malaria-free in 1974 and remained that way until 2011, when there was an outbreak of Plasmodium vivax malaria in Southern Greece.
The outbreak was linked to the presence of agricultural workers from malaria-endemic regions in malaria-receptive areas.
There were 21 P vivax cases from arriving immigrants reported in the Southern agricultural area of Evrotas, along with 36 local cases.
So Greece implemented an integrated control program, with house visits established to screen immigrants from malaria-endemic countries.
Screening included a rapid diagnostic test for those reporting symptoms associated with malaria, along with blood sampling for smear and molecular testing for malaria. Directly observed treatment was provided for all patients who tested positive.
A vector control program was also implemented, with indoor residual spraying and long-lasting insecticide nets provided in areas close to mosquito breeding sites.
Despite these interventions, 20 more cases of malaria were reported in 2012.
Due to fears that the malaria parasite may be re-establishing itself in the area, Greece implemented an MDA program. It consisted of a single course of chloroquine and primaquine, which are the first-line recommended antimalarials for P vivax.
The program was implemented prior to the onset of peak adult mosquito activity, and field teams remained in situ continuing the active case detection until the end of the mosquito season. They recorded and managed adverse events daily.
The researchers identified an immigrant population of 1270 individuals, mostly from Pakistan and Afghanistan. The MDA covered 87% of this population.
No malaria cases were reported for 2013 and 2014, when the MDA was ongoing.
Of the treated individuals, 13% reported gastrointestinal symptoms from primaquine, while 36% reported non-severe side effects from chloroquine, including headaches, dizziness, and gastrointestinal complaints.
One potentially serious adverse event was recorded. It was a case of primaquine-induced hemolysis due to a false-normal G6PD level obtained prior to enrollment. The patient was hospitalized and recovered fully.
The researchers said that, in this case, the MDA program was a suitable and effective response for a small and geographically confined population over a short seasonal transition period. And the combination of 2 drugs minimized the risk of drug resistance.
The team added that, although an observational study of this nature cannot assess the extent to which the MDA program was responsible for eliminating malaria, it indicates that MDA should be considered and can be effective in local settings alongside other malaria control measures.