Evidence map›Paper›PMID 32334702›Full record

Trial reportLancet (London, England)2020

Effectiveness of reactive focal mass drug administration and reactive focal vector control to reduce malaria transmission in the low malaria-endemic setting of Namibia: a cluster-randomised controlled, open-label, two-by-two factorial design trial.

Michelle S Hsiang, Henry Ntuku, Kathryn W Roberts, Mi-Suk Kang Dufour, Brooke Whittemore, Munyaradzi Tambo, Patrick McCreesh, Oliver F Medzihradsky, Lisa M Prach, Griffith Siloka and 18 more

2 registry-linked trialsOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Lancet (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 53 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 6 pooled it
11.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02610400 phase3completednot on this map

Targeted Parasite Elimination in the Human and Mosquito to Reduce Malaria Transmission: A Cluster Randomised Controlled Factorial Design Trial of Reactive Focal Drug Administration (rfMDA) Versus Reactive Case Detection (RACD), With and Without Reactive Vector Control (RAVC), From the Low Endemic Setting of Namibia

TypeinterventionalSponsorUniversity of California, San FranciscoRan2016 to 2017Enrolled9,845ConditionsMalariaArmsRACD, RAVC, rfMDA
NCT05690841 phase3recruitingnot on this mapstarted 2024, after this paper: background citation

FocaL Mass Drug Administration for Vivax Malaria Elimination (FLAME): a Pragmatic Cluster Randomized Controlled Trial in Peru

TypeinterventionalSponsorUniversity of California, San FranciscoRan2024 to 2027Enrolled7,530ConditionsPlasmodium Vivax Malaria, MalariaArmsFocal Mass Drug Administration (fMDA)
3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 6 syntheses or guidelines pooled it, 88 citations in OpenAlex.

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  10. Dihydroartemisinin-Piperaquine Chemoprevention and Malaria Incidence After Severe Flooding: Evaluation of a Pragmatic Intervention in Rural Uganda.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

28 authors at 7 institutions in 4 countries.

Michelle S HsiangDepartment of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA; Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA. Electronic address: michelle.hsiang@utsouthwestern.edu.
Henry NtukuMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA.
Kathryn W RobertsMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA.
Mi-Suk Kang DufourDivision of Prevention Science, University of California San Francisco, San Francisco, CA, USA.
Brooke WhittemoreDepartment of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Munyaradzi TamboMultidisciplinary Research Centre, University of Namibia, Windhoek, Namibia.
Patrick McCreeshDepartment of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA; Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA.
Oliver F MedzihradskyMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA; Department of Pediatrics, University of California San Francisco, San Francisco, CA, USA.
Lisa M PrachMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA.
Griffith SilokaZambezi Ministry of Health and Social Services, Katima, Namibia.
Noel SiameZambezi Ministry of Health and Social Services, Katima, Namibia.
Cara Smith GueyeMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA.
Leah SchrubbeMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA.
Lindsey WuDepartment of Immunology and Infection, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
Valerie ScottMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA.
Sofonias TessemaDivision of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Bryan GreenhouseDivision of Experimental Medicine, Department of Medicine, University of California San Francisco, San Francisco, CA, USA.
Erica ErlankWits Research Institute for Malaria, South African Medical Research Council Collaborating Centre for Multi-Disciplinary Research on Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Lizette L KoekemoerWits Research Institute for Malaria, South African Medical Research Council Collaborating Centre for Multi-Disciplinary Research on Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Hugh J W SturrockMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA.
Agnes MwilimaZambezi Ministry of Health and Social Services, Katima, Namibia.
Stark KatokeleNational Vector-Borne Diseases Control Programme, Namibia Ministry of Health and Social Services, Windhoek, Namibia.
Petrina UusikuNational Vector-Borne Diseases Control Programme, Namibia Ministry of Health and Social Services, Windhoek, Namibia.
Adam BennettMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA.
Jennifer L SmithMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA.
Immo KleinschmidtDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK; Wits Research Institute for Malaria, South African Medical Research Council Collaborating Centre for Multi-Disciplinary Research on Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Southern African Development Community, Malaria Elimination Eight Secretariat, Windhoek, Namibia.
Davis MumbengegwiMultidisciplinary Research Centre, University of Namibia, Windhoek, Namibia.
Roly GoslingMalaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, CA, USA; Multidisciplinary Research Centre, University of Namibia, Windhoek, Namibia.
University of California, San Francisco · USMinistry of Health and Social Services · NASouth African Medical Research Council · ZAUniversity of Namibia · NALondon School of Hygiene & Tropical Medicine · GBThe University of Texas Southwestern Medical Center · USUniversity of the Witwatersrand · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn low malaria-endemic settings, screening and treatment of individuals in close proximity to index cases, also known as reactive case detection (RACD), is practised for surveillance and response. However, other approaches could be more effective for reducing transmission. We aimed to evaluate the effectiveness of reactive focal mass drug administration (rfMDA) and reactive focal vector control (RAVC) in the low malaria-endemic setting of Zambezi (Namibia).

methodsWe did a cluster-randomised controlled, open-label trial using a two-by-two factorial design of 56 enumeration area clusters in the low malaria-endemic setting of Zambezi (Namibia). We randomly assigned these clusters using restricted randomisation to four groups: RACD only, rfMDA only, RAVC plus RACD, or rfMDA plus RAVC. RACD involved rapid diagnostic testing and treatment with artemether-lumefantrine and single-dose primaquine, rfMDA involved presumptive treatment with artemether-lumefantrine, and RAVC involved indoor residual spraying with pirimiphos-methyl. Interventions were administered within 500 m of index cases. To evaluate the effectiveness of interventions targeting the parasite reservoir in humans (rfMDA vs RACD), in mosquitoes (RAVC vs no RAVC), and in both humans and mosquitoes (rfMDA plus RAVC vs RACD only), an intention-to-treat analysis was done. For each of the three comparisons, the primary outcome was the cumulative incidence of locally acquired malaria cases. This trial is registered with ClinicalTrials.gov, number NCT02610400.

findingsBetween Jan 1, 2017, and Dec 31, 2017, 55 enumeration area clusters had 1118 eligible index cases that led to 342 interventions covering 8948 individuals. The cumulative incidence of locally acquired malaria was 30·8 per 1000 person-years (95% CI 12·8-48·7) in the clusters that received rfMDA versus 38·3 per 1000 person-years (23·0-53·6) in the clusters that received RACD; 30·2 per 1000 person-years (15·0-45·5) in the clusters that received RAVC versus 38·9 per 1000 person-years (20·7-57·1) in the clusters that did not receive RAVC; and 25·0 per 1000 person-years (5·2-44·7) in the clusters that received rfMDA plus RAVC versus 41·4 per 1000 person-years (21·5-61·2) in the clusters that received RACD only. After adjusting for imbalances in baseline and implementation factors, the incidence of malaria was lower in clusters receiving rfMDA than in those receiving RACD (adjusted incidence rate ratio 0·52 [95% CI 0·16-0·88], p=0·009), lower in clusters receiving RAVC than in those that did not (0·48 [0·16-0·80], p=0·002), and lower in clusters that received rfMDA plus RAVC than in those receiving RACD only (0·26 [0·10-0·68], p=0·006). No serious adverse events were reported.

interpretationIn a low malaria-endemic setting, rfMDA and RAVC, implemented alone and in combination, reduced malaria transmission and should be considered as alternatives to RACD for elimination of malaria.

fundingNovartis Foundation, Bill & Melinda Gates Foundation, and Horchow Family Fund.

Indexed as

Mosquito ControlAntimalarialsArtemether, Lumefantrine Drug CombinationCluster AnalysisHumansMalaria, FalciparumMass Drug AdministrationNamibiaPlasmodium falciparumSeroepidemiologic StudiesAntimalarialsArtemether, Lumefantrine Drug Combination

Identifiers

PMID32334702
PMCPMC7184675
OpenAlexW3019315235

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.