Implementing population‑based mass drug administration for malaria: experience from a high transmission setting in North Eastern Uganda
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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Malaria Journal
Abstract
Mass drug administration (MDA) is a suggested mean to accelerate efforts towards elimination and
attainment of malaria-free status. There is limited evidence of suitable methods of implementing MDA programme to
achieve a high coverage and compliance in low-income countries. The objective of this paper is to assess the impact
of this MDA delivery strategy while using coverage measured as effective population in the community and population
available.
Methods: Population-based MDA was implemented as a part of a larger program in a high transmission setting in
Uganda. Four rounds of interventions were implemented over a period of 2 years at an interval of 6 to 8 months. A
housing and population census was conducted to establish the eligible population. A team of 19 personnel conducted
MDA at established village meeting points as distribution sites at every village. The first dose of dihydroartemisinin–
piperaquine (DHA-PQ) was administered via a fixed site distribution strategy by directly observed treatment
on site, the remaining doses were taken at home and a door-to-door follow up strategy was implemented by community
health workers to monitor adherence to the second and third doses.
Results: Based on number of individuals who turned up at the distribution site, for each round of MDA, effective coverage
was 80.1%, 81.2%, 80.0% and 80% for the 1st, 2nd, 3rd and 4th rounds respectively. However, coverage based
on available population at the time of implementing MDA was 80.1%, 83.2%, 82.4% and 82.9% for rounds 1, 2, 3 and
4, respectively. Intense community mobilization using community structures and mass media facilitated community
participation and adherence to MDA.
Conclusion: A hybrid of fixed site distribution and door-to-door follow up strategy of MDA delivery achieved a high
coverage and compliance and seemed feasible. This model can be considered in resource-limited settings.
Description
Keywords
Malaria, Mass drug administration, High transmission setting, Uganda
Citation
Mulebeke, R., Wanzira, H., Bukenya, F., Eganyu, T., Collborn, K., Elliot, R., ... & Yeka, A. (2019). Implementing population-based mass drug administration for malaria: experience from a high transmission setting in North Eastern Uganda. Malaria Journal, 18(1), 1-10. https://doi.org/10.1186/s12936-019-2902-z