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  1. Article ; Online: Mass Drug Administration: Contextual Factor Considerations.

    Schneider, Zachary D / Busbee, Alexandra L / Boily, Marisa C / Shah, Monica P / Hwang, Jimee / Lindblade, Kim A / Gutman, Julie R

    The American journal of tropical medicine and hygiene

    2024  Volume 110, Issue 4_Suppl, Page(s) 30–37

    Abstract: In designing mass drug administration (MDA) campaigns, it is imperative to consider contextual factors that affect uptake of the intervention, including acceptability, cost, feasibility, and health system considerations, to ensure optimal coverage. We ... ...

    Abstract In designing mass drug administration (MDA) campaigns, it is imperative to consider contextual factors that affect uptake of the intervention, including acceptability, cost, feasibility, and health system considerations, to ensure optimal coverage. We reviewed the literature on contextual factors influencing MDA delivery to provide programs with information to design a successful campaign. From 1,044 articles screened, 37 included contextual factors relevant to participants' values and preferences, drivers of MDA acceptability, health equity concerns, financial and economic aspects, and feasibility barriers; 13 included relevant modeling data. Key findings were abstracted by two reviewers and summarized. No studies directly assessed values or direct health equity concerns with respect to MDA, which represents an evidence gap as unequal distributions of effects and factors that impact participant acceptability and program feasibility must be considered to ensure equitable access. Participant acceptability was the most widely surveyed factor, appearing in 28 of 37 studies; perceived adverse events were a frequently noted cause of nonparticipation, mentioned in 15 studies. Feasibility considerations included when, where, and how drugs will be delivered and how to address pregnant women, as these can all have substantial implications for participation. Mass drug administration costs (∼$1.04 to $19.40 per person per round) are driven primarily by drug prices, but the delivery mechanism can have varying costs as well, and integration with other interventions may provide cost savings. Both programmatic goals and sociopolitical and economic contexts must be carefully considered before embarking on an MDA program to ensure programmatic success.
    MeSH term(s) Humans ; Female ; Pregnancy ; Mass Drug Administration ; Pregnant Women ; Health Equity ; Cost Savings ; Surveys and Questionnaires
    Language English
    Publishing date 2024-01-23
    Publishing country United States
    Document type Review ; Journal Article
    ZDB-ID 2942-7
    ISSN 1476-1645 ; 0002-9637
    ISSN (online) 1476-1645
    ISSN 0002-9637
    DOI 10.4269/ajtmh.22-0767
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Mass Drug Administration to Reduce Malaria Transmission: A Systematic Review and Meta-Analysis.

    Schneider, Zachary D / Shah, Monica P / Boily, Marisa C / Busbee, Alexandra L / Hwang, Jimee / Lindblade, Kim A / Gutman, Julie R

    The American journal of tropical medicine and hygiene

    2023  Volume 110, Issue 4_Suppl, Page(s) 17–29

    Abstract: Malaria remains a significant cause of morbidity and mortality, even in low-transmission settings. With the advent of longer acting, more effective, and well-tolerated antimalarials, there is renewed interest in the efficacy of mass drug administration ( ... ...

    Abstract Malaria remains a significant cause of morbidity and mortality, even in low-transmission settings. With the advent of longer acting, more effective, and well-tolerated antimalarials, there is renewed interest in the efficacy of mass drug administration (MDA) to accelerate to elimination. We conducted a systematic review and meta-analysis to assess the efficacy of MDA to reduce the incidence and prevalence of Plasmodium falciparum (Pf) and Plasmodium vivax (Pv) infection. From 1,044 articles screened, 14 articles, including 10 randomized controlled trials (RCTs), were identified. Five included data on Pf only; five included Pf and Pv. Two of the Pf studies were conducted in areas of high-moderate transmission, the remainder were in areas of low-very low transmission. In higher transmission areas, MDA reduced incidence of Pf parasitemia (rate ratio = 0.61, 95% CI: 0.40-0.92; moderate certainty) 1 to 3 months after drug administration; no significant effect of MDA on Pf parasitemia prevalence was detected 1 to 3 months post-MDA (risk ratio [RR] = 1.76, 95% CI: 0.58-5.36; low certainty). In lower transmission settings, both incidence and prevalence of Pf parasitemia were reduced 1 to 3 months post-MDA (rate ratio = 0.37, 95% CI: 0.21-0.66; RR = 0.25, 95% CI: 0.15-0.41, respectively). Pv prevalence was reduced 1 to 3 months post-MDA (RR = 0.15, 95% CI: 0.10-0.24); there were no RCTs providing data on incidence of Pv. There was no significant effect of MDA at later time points. MDA may have short-term benefits; however, there was no evidence for longer term impact, although none of the trials assessed prolonged interventions.
    MeSH term(s) Humans ; Mass Drug Administration ; Parasitemia/prevention & control ; Parasitemia/drug therapy ; Antimalarials/therapeutic use ; Antimalarials/pharmacology ; Malaria/drug therapy ; Malaria, Vivax/drug therapy ; Malaria, Vivax/epidemiology ; Malaria, Vivax/prevention & control ; Plasmodium falciparum
    Chemical Substances Antimalarials
    Language English
    Publishing date 2023-12-20
    Publishing country United States
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 2942-7
    ISSN 1476-1645 ; 0002-9637
    ISSN (online) 1476-1645
    ISSN 0002-9637
    DOI 10.4269/ajtmh.22-0766
    Database MEDical Literature Analysis and Retrieval System OnLINE

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