ArticlePloS one2016
Impact and Lessons Learned from Mass Drug Administrations of Malaria Chemoprevention during the Ebola Outbreak in Monrovia, Liberia, 2014.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Mass drug administration for malaria.The Cochrane database of systematic reviews · 2021Pooled it
- Community engagement and population coverage in mass anti-malarial administrations: a systematic literature review.Malaria journal · 2016Pooled it
- Operational performance of a programmatic mass drug administration campaign for malaria in southern Mozambique: a comprehensive mixed-methods evaluation of implementation outcomes.BMC public health · 2026Article
- Azithromycin mass drug administration to reduce childhood mortality in humanitarian crises.PLOS global public health · 2026Review
- Evaluation of in vitro drug-drug interactions of ivermectin and antimalarial compounds.Malaria journal · 2025Article
- Process and Methodological Considerations for Observational Analyses of Vector Control Interventions in Sub-Saharan Africa Using Routine Malaria Data.The American journal of tropical medicine and hygiene · 2025Article
- Article
- Modelling mass drug administration strategies for reducing scabies burden in Monrovia, Liberia.Epidemiology and infection · 2023Article
- Effect of large-scale mass drug administration for malaria on mortality and morbidity in Angumu health zone, Ituri, Democratic Republic of Congo.Malaria journal · 2023Article
- Delivery of seasonal malaria chemoprevention with enhanced infection prevention and control measures during the COVID-19 pandemic in Nigeria, Burkina Faso and Chad: a cross-sectional study.Malaria journal · 2022Article
- Community engagement for malaria elimination in the Greater Mekong Sub-region: a qualitative study among malaria researchers and policymakers.Malaria journal · 2022Article
- Development of weight and age-based dosing of daily primaquine for radical cure of vivax malaria.Malaria journal · 2021Article
- Seeking research questions from implementers: considerations for leveraging ground actors research needs in the fight against malaria in West Africa.Malaria journal · 2021Article
- Use-case scenarios for an anti-Cryptosporidium therapeutic.PLoS neglected tropical diseases · 2021Review
- Estimating malaria chemoprevention and vector control coverage using program and campaign data: A scoping review of current practices and opportunities.Journal of global health · 2020Article
- The impact of COVID-19 pandemic on malaria elimination.Parasite epidemiology and control · 2020Review
- Mass campaigns combining antimalarial drugs and anti-infective vaccines as seasonal interventions for malaria control, elimination and prevention of resurgence: a modelling study.BMC infectious diseases · 2019Article
- Implementing population-based mass drug administration for malaria: experience from a high transmission setting in North Eastern Uganda.Malaria journal · 2019Article
- Challenges and perceptions of implementing mass testing, treatment and tracking in malaria control: a qualitative study in Pakro sub-district of Ghana.BMC public health · 2019Article
- Single low-dose primaquine for blocking transmission of Plasmodium falciparum malaria - a proposed model-derived age-based regimen for sub-Saharan Africa.BMC medicine · 2018Article
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Authors and funding
10 authors at 6 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn October 2014, during the Ebola outbreak in Liberia healthcare services were limited while malaria transmission continued. Médecins Sans Frontières (MSF) implemented a mass drug administration (MDA) of malaria chemoprevention (CP) in Monrovia to reduce malaria-associated morbidity. In order to inform future interventions, we described the scale of the MDA, evaluated its acceptance and estimated the effectiveness.
methodsMSF carried out two rounds of MDA with artesunate/amodiaquine (ASAQ) targeting four neighbourhoods of Monrovia (October to December 2014). We systematically selected households in the distribution area and administered standardized questionnaires. We calculated incidence ratios (IR) of side effects using poisson regression and compared self-reported fever risk differences (RD) pre- and post-MDA using a z-test.
findingsIn total, 1,259,699 courses of ASAQ-CP were distributed. All households surveyed (n = 222; 1233 household members) attended the MDA in round 1 (r1) and 96% in round 2 (r2) (212/222 households; 1,154 household members). 52% (643/1233) initiated ASAQ-CP in r1 and 22% (256/1154) in r2. Of those not initiating ASAQ-CP, 29% (172/590) saved it for later in r1, 47% (423/898) in r2. Experiencing side effects in r1 was not associated with ASAQ-CP initiation in r2 (IR 1.0, 95%CI 0.49-2.1). The incidence of self-reported fever decreased from 4.2% (52/1229) in the month prior to r1 to 1.5% (18/1229) after r1 (p<0.001) and decrease was larger among household members completing ASAQ-CP (RD = 4.9%) compared to those not initiating ASAQ-CP (RD = 0.6%) in r1 (p<0.001).
conclusionsThe reduction in self-reported fever cases following the intervention suggests that MDAs may be effective in reducing cases of fever during Ebola outbreaks. Despite high coverage, initiation of ASAQ-CP was low. Combining MDAs with longer term interventions to prevent malaria and to improve access to healthcare may reduce both the incidence of malaria and the proportion of respondents saving their treatment for future malaria episodes.
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