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Cited by 108Malaria Research and ControlHistory of Medicine and Tropical HealthHemoglobinopathies and Related Disorders

Population-Wide malaria testing and treatment with rapid diagnostic tests and artemether-lumefantrine in southern Zambia: a community randomized step-wedge control trial design

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Larsen, David A., Bennett, Adam, Silumbe, Kafula, Hamainza, Busiku, Yukich, Joshua O., Keating, Joseph, Littrell, Megan, Miller, John M. +2 more·2015·The American Society of Tropical Medicine and Hygiene
DOI 10.4269/ajtmh.14-0347PMC PMC4426577
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Abstract

Reducing the human reservoir of malaria parasites is critical for elimination. We conducted a community randomized controlled trial in Southern Province, Zambia to assess the impact of three rounds of a mass test and treatment (MTAT) intervention on malaria prevalence and health facility outpatient case incidence using random effects logistic regression and negative binomial regression, respectively. Following the intervention, children in the intervention group had lower odds of a malaria infection than individuals in the control group (adjusted odds ratio = 0.47, 95% confidence interval [CI] = 0.24–0.90). Malaria outpatient case incidence decreased 17% in the intervention group relative to the control group (incidence rate ratio = 0.83, 95% CI = 0.68–1.01). Although a single year of MTAT reduced malaria prevalence and incidence, the impact of the intervention was insufficient to reduce transmission to a level approaching elimination where a strategy of aggressive case investigations could be used. Mass drug administration, more sensitive diagnostics, and gametocidal drugs may potentially improve interventions targeting the human reservoir of malaria parasites.

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  • Studies that integrated health facility-based interventions with community outreach often used mixed-setting clusters.

    “Studies that integrated health facility-based interventions with community outreach often used mixed-setting clusters (33–36, 38, 48, 54, 61, 67, 72, 76, 78, 80, 92, 99, 103, 106–108).”

    From Applications and implementation considerations for stepped-wedge designs in sub-Saharan Africa: a systematic review (2026) · cites this paper as [38]

    The Methods (Study design; page unavailable) describe clusters made up of health-facility catchment areas, and the Methods (Intervention; page unavailable) describe door-to-door community testing and treatment. The paper does not describe a health facility-based intervention integrated with that outreach: facilities supplied an outcome measure and received some referrals. This study therefore supports the mixed-setting cluster description, but not the full characterization of the intervention. (LLM, conf=0.84)

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Cited by

Sorted by citations

Authors
Larsen, D. A., Bennett, A., Silumbe, K., Hamainza, B., Yukich, J. O., Keating, J., Littrell, M., Miller, J. M., Steketee, R. W., & Eisele, T. P.
Affiliations
Tulane University (US)
Corresponding author
Eisele, Thomas P.
ORCID
Venue
The American Society of Tropical Medicine and Hygiene
Publisher
American Society of Tropical Medicine and Hygiene
Published
2015-05-06
Volume
92
Issue
5
Pages
913-921
ISSN
  • 0002-9637 (ISSN-L)
  • 1476-1645
DOI
10.4269/ajtmh.14-0347
PMC
PMC4426577
OpenAlex
W1987603702
Cited by
108
References
5
Citations by year
2026: 2 · 2025: 5 · 2024: 9 · 2023: 8 · 2022: 3 · 2021: 12 · 2020: 33 · 2019: 9 · 2018: 7 · 2017: 7 · 2016: 9 · 2015: 4
FWCI
9.65
Type
journal article
Language
en
Open access
Locations
  • American Journal of Tropical Medicine and Hygiene (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Social Sciences › Arts and Humanities › History › History of Medicine and Tropical Health
  • Health Sciences › Medicine › Genetics › Hemoglobinopathies and Related Disorders
Keywords
malaria elimination, rapid diagnostic tests, artemether-lumefantrine, mass drug administration, malaria prevalence, children, Southern Province, Zambia
MeSH terms
Artemether, Lumefantrine Drug Combination, Antimalarials, Child, Preschool, Diagnostic Tests, Routine, Drug Combinations, Ethanolamines, Female, Fluorenes, Follow-Up Studies, Geography, Humans, Infant, Malaria, Male, Mass Screening, Residence Characteristics, Zambia, Incidence, Prevalence, Artemisinins

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