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Title: Towards malaria elimination in Savannakhet, Lao PDR: Mathematical modelling driven strategy design
Authors: Sai Thein Than Tun
Lorenz Von Seidlein
Tiengkham Pongvongsa
Mayfong Mayxay
Sompob Saralamba
Shwe Sin Kyaw
Phetsavanh Chanthavilay
Olivier Celhay
Tran Dang Nguyen
Thu Nguyen Anh Tran
Daniel M. Parker
Maciej F. Boni
Arjen M. Dondorp
Lisa J. White
Mahidol University
Churchill Hospital
Savannakhet Provincial Health Department
Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU)
University of Health Sciences
Institute of Francophonie for Tropical Medicine
Oxford University Clinical Research Unit
Pennsylvania State University
Keywords: Immunology and Microbiology
Issue Date: 28-Nov-2017
Citation: Malaria Journal. Vol.16, No.1 (2017)
Abstract: © 2017 The Author(s). Background: The number of Plasmodium falciparum malaria cases around the world has decreased substantially over the last 15 years, but with the spread of resistance against anti-malarial drugs and insecticides, this decline may not continue. There is an urgent need to consider alternative, accelerated strategies to eliminate malaria in countries like Lao PDR, where there are a few remaining endemic areas. A deterministic compartmental modelling tool was used to develop an integrated strategy for P. falciparum elimination in the Savannakhet province of Lao PDR. The model was designed to include key aspects of malaria transmission and integrated control measures, along with a user-friendly interface. Results: Universal coverage was the foundation of the integrated strategy, which took the form of the deployment of community health workers who provided universal access to early diagnosis, treatment and long-lasting insecticidal nets. Acceleration was included as the deployment of three monthly rounds of mass drug administration targeted towards high prevalence villages, with the addition of three monthly doses of the RTS,S vaccine delivered en masse to the same high prevalence sub-population. A booster dose of vaccine was added 1 year later. The surveillance-as-intervention component of the package involved the screening and treatment of individuals entering the simulated population. Conclusions: In this modelling approach, the sequential introduction of a series of five available interventions in an integrated strategy was predicted to be sufficient to stop malaria transmission within a 3-year period. These interventions comprised universal access to early diagnosis and adequate treatment, improved access to long-lasting insecticidal nets, three monthly rounds of mass drug administration together with RTS,S vaccination followed by a booster dose of vaccine, and screening and treatment of imported cases.
ISSN: 14752875
Appears in Collections:Scopus 2016-2017

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