Malaria elimination

A series of large trials on the use of targeted mass drug administration (MDA) as a tool for malaria elimination in the region has been completed with sites in Myanmar, Cambodia, Lao PDR and Vietnam. These studies show good efficacy and acceptable safety of dihydroartemisininpiperaquine with or without low dose primaquine, and the importance of community engagement to achieve high population coverage. Social science studies were conducted to understand factors which motivate target populations for malaria control activities towards participation.

We also described the dynamics of asymptomatic parasitaemia over time, crucial for defining the contribution of the asymptomatic reservoir to malaria transmission in low transmission settings and informing policy makers.

Studies were completed assessing the safety and benefit of ivermectin in malaria control, understanding the effect of population level MDA on vector infectivity, and understanding the aspects of housing which protect against vector entrance.

A large healthy volunteer study showed that the RTS,S/AS01 vaccine was well tolerated and immunogenic, and had no interactions with DHA-piperaquine. Modelling has shown that vaccination with RTS,S is a potentially useful adjunct to MDA in elimination campaigns.

A systematic review on the risk of sudden unexplained death after dihydroartemisinin-piperaquine was completed, which showed the safety of this drug combination and informed the WHO treatment guidelines.