Advances 4: Mass treatment as a malaria elimination accelerator
Where malaria transmission is low the prospects for elimination
increase. In the Greater Mekong subregion (GMS), which harbours the most
drug resistant P. falciparum in the world, there is a general
consensus that the only way to counter multi-drug resistance effectively
is to eliminate all falciparum malaria. This is an area of low seasonal
malaria transmission and targeted malaria elimination, even in the most
remote and inaccessible areas, has been very effective (34, 35). The key
to successful elimination is the support of village health workers in
every village (usually 300-800 people) to provide diagnosis of malaria
with a rapid diagnostic test, and treatment with an effective ACT (36).
In foci of higher transmission (sometimes called “hot spots’), where a
significant proportion of the healthy population have asymptomatic
parasitaemias, mass treatments with dihydroartemisinin-piperaquine have
proved very effective and well tolerated “accelerators” of elimination
(34,35).