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1. Efficacy of attractive targeted sugar bait stations against malaria in Western Province Zambia: epidemiological findings from a two-arm cluster randomized phase III trial

Author

Ashton, Ruth A., Saili, Kochelani, Chishya, Chama, Banda Yikona, Handrinah, Arnzen, Annie, Orange, Erica, Chitoshi, Chanda, Chulu, John, Tobolo, Titus, Ndalama, Frank, Kyomuhangi, Irene, Ngulube, Willy, Moonga, Hawela, Chirwa, Jacob, Slutsker, Laurence, Wagman, Joseph, Chanda, Javan, Miller, John, Silumbe, Kafula, Hamainza, Busiku, Eisele, Thomas P., Yukich, Joshua, and Littrell, Megan

Published
2024
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2. Why does malaria transmission continue at high levels despite universal vector control? Quantifying persistent malaria transmission by Anopheles funestus in Western Province, Zambia

Author

Ashton, Ruth A., Chanda, Benjamin, Chishya, Chama, Muyabe, Rayford, Kaniki, Tresford, Mambo, Patricia, Mwenya, Mwansa, Mwaanga, Gift, Arnzen, Annie, Orange, Erica, Saili, Kochelani, Banda Yikona, Handrinah, Chulu, John, Chitoshi, Chanda, Kyomuhangi, Irene, Miller, John, Silumbe, Kafula, Hamainza, Busiku, Littrell, Megan, Yukich, Joshua, Kleinschmidt, Immo, Chanda, Javan, Wagman, Joseph, and Eisele, Thomas P.

Published
2024
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4. Community acceptance of a novel malaria intervention, Attractive Targeted Sugar Baits, in the Zambia phase III trial

Author

Orange, Erica, Arnzen, Annie, Muluma, Chuma, Akalalambili, Situmbeko, Tobolo, Titus, Ndalama, Frank, Chishya, Chama, Saili, Kochelani, Ashton, Ruth A., Eisele, Thomas P., Yukich, Joshua, Kyomuhangi, Irene, Miller, John, Silumbe, Kafula, Chanda, Javan, Hamainza, Busiku, Wagman, Joseph, Slutsker, Laurence, Burkot, Thomas R., and Littrell, Megan

Published
2024
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5. Deployment of attractive targeted sugar baits in western Zambia: installation, monitoring, removal, and disposal procedures during a Phase III cluster randomized controlled trial

Author

Orange, Erica, Kyomuhangi, Irene, Masuzyo, Mundia, Mwenya, Mwansa, Mambo, Patricia, Saili, Kochelani, Chishya, Chama, Chanda, Javan, Ashton, Ruth A., Eisele, Thomas P., Yukich, Joshua, Miller, John, Silumbe, Kafula, Hamainza, Busiku, Wagman, Joseph, Arnzen, Annie, Harris, Angela F., Entwistle, Julian, Slutsker, Laurence, Burkot, Thomas R., and Littrell, Megan

Published
2024
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6. Characteristics of the Western Province, Zambia, trial site for evaluation of attractive targeted sugar baits for malaria vector control

Author

Arnzen, Annie, Wagman, Joseph, Chishya, Chama, Orange, Erica, Eisele, Thomas P., Yukich, Joshua, Ashton, Ruth A., Chanda, Javan, Sakala, Jimmy, Chanda, Benjamin, Muyabe, Rayford, Kaniki, Tresford, Mwenya, Mwansa, Mwaanga, Gift, Eaton, Will T., Mancuso, Brooke, Mungo, Alice, Mburu, Monicah M., Bubala, Nchimunya, Hagwamuna, Ackim, Simulundu, Edgar, Saili, Kochelani, Miller, John M., Silumbe, Kafula, Hamainza, Busiku, Ngulube, Willy, Moonga, Hawela, Chirwa, Jacob, Burkot, Thomas R., Slutsker, Laurence, and Littrell, Megan

Published
2024
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7. Malaria Risk Mapping Using Routine Health System Incidence Data in Zambia

Author

Taylor, Benjamin M., Andrade-Pacheco, Ricardo, Sturrock, Hugh, Hamainza, Busiku, Silumbe, Kafula, Miller, John, Eisele, Thomas P., Rerolle, Francois, Slater, Hannah, and Bennett, Adam

Subjects
Statistics - Applications
Abstract

Improvements to Zambia's malaria surveillance system allow better monitoring of incidence and targetting of responses at refined spatial scales. As transmission decreases, understanding heterogeneity in risk at fine spatial scales becomes increasingly important. However, there are challenges in using health system data for high-resolution risk mapping: health facilities have undefined and overlapping catchment areas, and report on an inconsistent basis. We propose a novel inferential framework for risk mapping of malaria incidence data based on formal down-scaling of confirmed case data reported through the health system in Zambia. We combine data from large community intervention trials in 2011-2016 and model health facility catchments based upon treatment-seeking behaviours; our model for monthly incidence is an aggregated log-Gaussian Cox process, which allows us to predict incidence at fine scale. We predicted monthly malaria incidence at 5km$^2$ resolution nationally: whereas 4.8 million malaria cases were reported through the health system in 2016, we estimated that the number of cases occurring at the community level was closer to 10 million. As Zambia continues to scale up community-based reporting of malaria incidence, these outputs provide realistic estimates of community-level malaria burden as well as high resolution risk maps for targeting interventions at the sub-catchment level.

Published
2021

10. Evaluating trends in damage to Attractive Targeted Sugar Baits deployed during the second year of a two-year Phase III trial in Western Zambia

Author

Kyomuhangi, Irene, primary, Yukich, Joshua, additional, Saili, Kochelani, additional, Orange, Erica, additional, Masuzyo, Mundia H., additional, Mwenya, Mwansa, additional, Mambo, Patricia, additional, Hamainza, Busiku, additional, Wagman, Joe, additional, Miller, John, additional, Chanda, Javan, additional, Silumbe, Kafula, additional, Littrell, Megan, additional, Eisele, Thomas P., additional, and Ashton, Ruth A., additional

Published
2024
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11. Deployment of Attractive Targeted Sugar Baits in Western Zambia: installation, monitoring, removal, and disposal procedures during a Phase III cluster randomized control trial.

Author

Orange, Erica, primary, Kyomuhangi, Irene, additional, Masuzyo, Mundia, additional, Mwenya, Mwansa, additional, Mambo, Patricia, additional, Saili, Kochelani, additional, Chishya, Chama, additional, Chanda, Javan, additional, Ashton, Ruth A., additional, Eisele, Thomas P., additional, Yukich, Joshua, additional, Miller, John, additional, Silumbe, Kafula, additional, Hamainza, Busiku, additional, Wagman, Joseph, additional, Arnzen, Annie, additional, Harris, Angela F, additional, Entwistle, Julian, additional, Slutsker, Laurence, additional, Burkot, Thomas R, additional, and Littrell, Megan, additional

Published
2024
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12. Entomological effects of attractive targeted sugar bait station deployment in Western Zambia: vector surveillance findings from a two-arm cluster randomized phase III trial.

Author

Wagman, Joseph, Chanda, Benjamin, Chanda, Javan, Saili, Kochelani, Orange, Erica, Mambo, Patricia, Muyabe, Rayford, Kaniki, Tresford, Mwenya, Mwansa, Ng'andu, Mirabelle, Sakala, Jimmy, Ngulube, Willy, Miller, John, Arnzen, Annie, Silumbe, Kafula, Mwaanga, Gift, Simubali, Limonty, Mungo, Alice, Mburu, Monicah M., and Simulundu, Edgar

Abstract

Background: Attractive targeted sugar bait (ATSB) stations are a novel tool with potential to complement current approaches to malaria vector control. To assess the public health value of ATSB station deployment in areas of high coverage with standard vector control, a two-arm cluster-randomized controlled trial (cRCT) of Sarabi ATSB® stations (Westham Ltd., Hod-Hasharon, Israel) was conducted in Western Province, Zambia, a high-burden location were Anopheles funestus is the dominant vector. The trial included 70 clusters and was designed to measure the effect of ATSBs on case incidence and infection prevalence over two 7-month deployments. Reported here are results of the vector surveillance component of the study, conducted in a subset of 20 clusters and designed to provide entomological context to guide overall interpretation of trial findings. Methods: Each month, 200 paired indoor-outdoor human landing catch (HLC) and 200 paired light trap (LT) collections were conducted to monitor An. funestus parity, abundance, biting rates, sporozoite prevalence, and entomological inoculation rates (EIR). Results: During the study 20,337 female An. funestus were collected, 11,229 from control and 9,108 from intervention clusters. A subset of 3,131 HLC specimens were assessed for parity: The mean non-parous proportion was 23.0% (95% CI 18.2–28.7%, total n = 1477) in the control and 21.2% (95% CI 18.8–23.9%, total n = 1654) in the intervention arm, an OR = 1.05 (95% CI 0.82–1.34; p = 0.688). A non-significant reduction in LT abundance (RR = 0.65 [95% CI 0.30–1.40, p = 0.267]) was associated with ATSB deployment. HLC rates were highly variable, but model results indicate a similar non-significant trend with a RR = 0.68 (95%CI 0.22–2.00; p = 0.479). There were no effects on sporozoite prevalence or EIR. Conclusions: Anopheles funestus parity did not differ across study arms, but ATSB deployment was associated with a non-significant 35% reduction in vector LT density, results that are consistent with the epidemiological impact reported elsewhere. Additional research is needed to better understand how to maximize the potential impact of ATSB approaches in Zambia and other contexts. Trial registration number: This trial was registered with Clinicaltrials.gov (NCT04800055, 16 March 2021). [ABSTRACT FROM AUTHOR]

Published
2024
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13. Characteristics of the Western Province, Zambia Trial Site for Evaluation of Attractive Targeted Sugar Baits for Malaria Vector Control

Author

Arnzen, Annie, primary, Wagman, Joseph, additional, Chishya, Chama, additional, Orange, Erica, additional, Eisele, Thomas P., additional, Yukich, Joshua, additional, Ashton, Ruth A., additional, Chanda, Javan, additional, Sakala, Jimmy, additional, Chanda, Benjamin, additional, Muyabe, Rayford, additional, Kaniki, Tresford, additional, Mwenya, Mwansa, additional, Mwaanga, Gift, additional, Eaton, Will, additional, Mancuso, Brooke, additional, Mungo, Alice, additional, Mburu, Monicah M., additional, Bubala, Nchimunya, additional, Hagwamuna, Ackim, additional, Simulundu, Edgar, additional, Saili, Kochelani, additional, Miller, John M., additional, Silumbe, Kafula, additional, Hamainza, Busiku, additional, Ngulube, Willy, additional, Moonga, Hawela, additional, Chirwa, Jacob, additional, Burkot, Thomas R., additional, Slutsker, Laurence, additional, and Littrell, Megan, additional

Published
2024
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16. Additional file 1 of Effectiveness of community case management of malaria on severe malaria and inpatient malaria deaths in Zambia: a dose–response study using routine health information system data

Author

Ashton, Ruth A., Hamainza, Busiku, Lungu, Chris, Rutagwera, Marie-Reine I., Porter, Travis, Bennett, Adam, Hainsworth, Michael, Burnett, Sarah, Silumbe, Kafula, Slater, Hannah, Eisele, Thomas P., and Miller, John M.

Abstract

Additional file 1: Figure S1. Stacked area plot of number of health facilities and community health workers operating by month and province (left) and line plot of total inpatient admissions with confirmed malaria among all ages by month and province (right). Note that y-axes are variable between Provinces.

Published
2023
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17. Reactive focal drug administration associated with decreased malaria transmission in an elimination setting: Serological evidence from the cluster-randomized CoRE study

Author

Bridges, Daniel J., primary, Miller, John M., additional, Chalwe, Victor, additional, Moonga, Hawela, additional, Hamainza, Busiku, additional, Steketee, Richard W., additional, Mambwe, Brenda, additional, Mulube, Conceptor, additional, Wu, Lindsey, additional, Tetteh, Kevin K. A., additional, Drakeley, Chris, additional, Chishimba, Sandra, additional, Mwenda, Mulenga, additional, Silumbe, Kafula, additional, and Larsen, David A., additional

Published
2022
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18. Attractive targeted sugar bait phase III trials in Kenya, Mali, and Zambia

Author

Attractive Targeted Sugar Bait Phase III Trial Group, Eisele, Thomas P., Kleinschmidt, Immo, Sarrassat, Sophie, terKuile, Feiko, Miller, John, Chanda, Javan, Silumbe, Kafula, Samuels, Aaron, Janssen, Julia, Ogwang, Caroline, Bradley, John, Orange, Erica, Yukich, Josh, Ashton, Ruth, Kyomuhangi, Irene, Harris, Angela F., Doumbia, Seydou, Toure, Mahamoudou, Moumine, Mohamed, Majambere, Silas, Mburu, Monicah Mirai, Mwaanga, Gift, Simubali, Limonty, Simulundu, Edgar, Bennett, Adam, Slutsker, Laurence, Muller, Gunter, Ochomo, Eric, Gimnig, John, Johnson, Paul C.D., Wagman, Joseph, and Littrell, Megan

Abstract

Background: \ud Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) target night-time indoor biting mosquitoes and effectively reduce malaria transmission in rural settings across Africa, but additional vector control tools are needed to interrupt transmission. Attractive targeted sugar baits (ATSBs) attract and kill mosquitoes, including those biting outdoors. Deployment of ATSBs incorporating the insecticide dinotefuran was associated with major reductions in mosquito density and longevity in Mali. The impact of this promising intervention on malaria transmission and morbidity now needs to be determined in a range of transmission settings.\ud \ud Methods/design: \ud We will conduct three similar stand-alone, open-label, two-arm, cluster-randomized, controlled trials (cRCTs) in Mali, Kenya, and Zambia to determine the impact of ATSB + universal vector control versus universal vector control alone on clinical malaria. The trials will use a “fried-egg” design, with primary outcomes measured in the core area of each cluster to reduce spill-over effects. All household structures in the ATSB clusters will receive two ATSBs, but the impact will be measured in the core of clusters. Restricted randomization will be used. The primary outcome is clinical malaria incidence among children aged 5–14 years in Mali and 1–14 years in Kenya and Zambia. A key secondary outcome is malaria parasite prevalence across all ages. The trials will include 76 clusters (38 per arm) in Mali and 70 (35 per arm) in each of Kenya and Zambia. The trials are powered to detect a 30% reduction in clinical malaria, requiring a total of 3850 person-years of follow-up in Mali, 1260 person-years in Kenya, and 1610 person-years in Zambia. These sample sizes will be ascertained using two seasonal 8-month cohorts in Mali and two 6-month seasonal cohorts in Zambia. In Kenya, which has year-round transmission, four 6-month cohorts will be used (total 24 months of follow-up). The design allows for one interim analysis in Mali and Zambia and two in Kenya.\ud \ud Discussion: \ud Strengths of the design include the use of multiple study sites with different transmission patterns and a range of vectors to improve external validity, a large number of clusters within each trial site, restricted randomization, between-cluster separation to minimize contamination between study arms, and an adaptive trial design. Noted threats to internal validity include open-label design, risk of contamination between study arms, risk of imbalance of covariates across study arms, variation in durability of ATSB stations, and potential disruption resulting from the COVID-19 pandemic.\ud \ud Trial registration: \ud Zambia: ClinicalTrials.gov NCT04800055. Registered on March 15, 2021\ud \ud Mali: ClinicalTrials.gov NCT04149119. Registered on November 4, 2019\ud \ud Kenya: ClinicalTrials.gov NCT05219565. Registered on February 2, 2022.

Published
2022

19. Attractive Targeted Sugar Bait Phase III Trials in Kenya, Mali, and Zambia

Author

Eisele, Thomas P., primary, Kleinschmidt, Immo, additional, Sarrassat, Sophie, additional, terKuile, Feiko, additional, Miller, John M, additional, Chanda, Javan, additional, Silumbe, Kafula, additional, Samuels, Aaron, additional, Janssen, Julia, additional, Ogwang, Caroline, additional, Bradley, John, additional, Orange, Erica, additional, Yukich, Josh, additional, Ashton, Ruth, additional, Kyomuhangi, Irene, additional, Harris, Angela F, additional, Doumbia, Seydou, additional, Toure, Mahamoudou, additional, Moumine, Mohamed, additional, Majambere, Silas, additional, Mburu, Monicah Mirai, additional, Mwaanga, Gift, additional, Simubali, Limonty, additional, Simulundu, Edgar, additional, Bennett, Adam, additional, Slutsker, Laurence, additional, Muller, Gunter, additional, Ochomo, Eric, additional, Gimnig, John, additional, Johnson, Paul C.D., additional, Wagman, Joseph, additional, and Littrell, Megan, additional

Published
2022
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20. Evaluating the Impact of Programmatic Mass Drug Administration for Malaria in Zambia Using Routine Incidence Data.

Author

Fraser, Maya, Miller, John M, Silumbe, Kafula, Hainsworth, Michael, Mudenda, Mutinta, Hamainza, Busiku, Moonga, Hawela, Kawesha, Elizabeth Chizema, Mercer, Laina D, Bennett, Adam, Schneider, Kammerle, Slater, Hannah C, Eisele, Thomas P, Guinovart, Caterina, and Chizema Kawesha, Elizabeth

Subjects
MALARIA prevention, DRUG therapy for malaria, DISEASE incidence, MALARIA, RESEARCH funding, ANTIMALARIALS
Abstract

Background: In 2016, the Zambian National Malaria Elimination Centre started programmatic mass drug administration (pMDA) campaigns with dihydroartemisinin-piperaquine as a malaria elimination tool in Southern Province. Two rounds were administered, 2 months apart (coverage 70% and 57%, respectively). We evaluated the impact of 1 year of pMDA on malaria incidence using routine data.Methods: We conducted an interrupted time series with comparison group analysis on monthly incidence data collected at the health facility catchment area (HFCA) level, with a negative binomial model using generalized estimating equations. Programmatic mass drug administration was conducted in HFCAs with greater than 50 cases/1000 people per year. Ten HFCAs with incidence rates marginally above this threshold (pMDA group) were compared with 20 HFCAs marginally below (comparison group).Results: The pMDA HFCAs saw a 46% greater decrease in incidence at the time of intervention than the comparison areas (incidence rate ratio = 0.536; confidence interval = 0.337-0.852); however, incidence increased toward the end of the season. No HFCAs saw a transmission interruption.Conclusions: Programmatic mass drug administration, implemented during 1 year with imperfect coverage in low transmission areas with suboptimal vector control coverage, significantly reduced incidence. However, elimination will require additional tools. Routine data are important resources for programmatic impact evaluations and should be considered for future analyses. [ABSTRACT FROM AUTHOR]

Published
2022
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21. Cost-Effectiveness of Focal Mass Drug Administration and Mass Drug Administration with Dihydroartemisinin–Piperaquine for Malaria Prevention in Southern Province, Zambia: Results of a Community-Randomized Controlled Trial

Author

Yukich, Joshua O., primary, Scott, Callie, additional, Silumbe, Kafula, additional, Larson, Bruce A., additional, Bennett, Adam, additional, Finn, Timothy P., additional, Hamainza, Busiku, additional, Conner, Ruben O., additional, Porter, Travis R., additional, Keating, Joseph, additional, Steketee, Richard W., additional, Eisele, Thomas P., additional, and Miller, John M., additional

Published
2020
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22. Treatment Coverage Estimation for Mass Drug Administration for Malaria with Dihydroartemisinin–Piperaquine in Southern Province, Zambia

Author

Finn, Timothy P., primary, Yukich, Joshua O., additional, Bennett, Adam, additional, Porter, Travis R., additional, Lungu, Christopher, additional, Hamainza, Busiku, additional, Chizema Kawesha, Elizabeth, additional, Conner, Ruben O., additional, Silumbe, Kafula, additional, Steketee, Richard W., additional, Miller, John M., additional, Keating, Joseph, additional, and Eisele, Thomas P., additional

Published
2020
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23. Prevalence of Plasmodium falciparum and Non-falciparum Infections by Photo-Induced Electron Transfer–PCR in a Longitudinal Cohort of Individuals Enrolled in a Mass Drug Administration Trial in Southern Province, Zambia

Author

Chishimba, Sandra, primary, Mwenda, Mulenga, additional, Mambwe, Brenda, additional, Mulube, Conceptor, additional, Chalwe, Victor, additional, Moonga, Hawela, additional, Hamainza, Busiku, additional, Chizema-Kawesha, Elizabeth, additional, Steketee, Richard W., additional, Domingo, Gonzalo, additional, Fraser, Maya, additional, Kahn, Maria, additional, Pal, Sampa, additional, Silumbe, Kafula, additional, Conner, Ruben O., additional, Bennett, Adam, additional, Porter, Travis R., additional, Eisele, Thomas P., additional, Miller, John M., additional, and Bridges, Daniel J., additional

Published
2020
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24. Assessment of the Acceptability of Testing and Treatment during a Mass Drug Administration Trial for Malaria in Zambia Using Mixed Methods

Author

Silumbe, Kafula, primary, Finn, Timothy P., additional, Jennings, Todd, additional, Sikombe, Chilumba, additional, Chiyende, Elizabeth, additional, Hamainza, Busiku, additional, Chizema Kawesha, Elizabeth, additional, Eisele, Thomas P., additional, Earle, Duncan, additional, Steketee, Richard W., additional, and Miller, John M., additional

Published
2020
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25. A Longitudinal Cohort to Monitor Malaria Infection Incidence during Mass Drug Administration in Southern Province, Zambia

Author

Bennett, Adam, primary, Porter, Travis R., additional, Mwenda, Mulenga C., additional, Yukich, Joshua O., additional, Finn, Timothy P., additional, Lungu, Chris, additional, Silumbe, Kafula, additional, Mambwe, Brenda, additional, Chishimba, Sandra, additional, Mulube, Conceptor, additional, Bridges, Daniel J., additional, Hamainza, Busiku, additional, Slutsker, Laurence, additional, Steketee, Richard W., additional, Miller, John M., additional, and Eisele, Thomas P., additional

Published
2020
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26. Impact of Four Rounds of Mass Drug Administration with Dihydroartemisinin–Piperaquine Implemented in Southern Province, Zambia

Author

Eisele, Thomas P., primary, Bennett, Adam, additional, Silumbe, Kafula, additional, Finn, Timothy P., additional, Porter, Travis R., additional, Chalwe, Victor, additional, Hamainza, Busiku, additional, Moonga, Hawela, additional, Kooma, Emmanuel, additional, Chizema Kawesha, Elizabeth, additional, Kamuliwo, Mulakwa, additional, Yukich, Joshua O., additional, Keating, Joseph, additional, Schneider, Kammerle, additional, Conner, Ruben O., additional, Earle, Duncan, additional, Slutsker, Laurence, additional, Steketee, Richard W., additional, and Miller, John M., additional

Published
2020
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27. Recent Travel History and Plasmodium falciparum Malaria Infection in a Region of Heterogenous Transmission in Southern Province, Zambia

Author

Porter, Travis R., primary, Finn, Timothy P., additional, Silumbe, Kafula, additional, Chalwe, Victor, additional, Hamainza, Busiku, additional, Kooma, Emmanuel, additional, Moonga, Hawela, additional, Bennett, Adam, additional, Yukich, Joshua O., additional, Steketee, Richard W., additional, Keating, Joseph, additional, Miller, John M., additional, and Eisele, Thomas P., additional

Published
2020
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28. Adherence to Mass Drug Administration with Dihydroartemisinin–Piperaquine and Plasmodium falciparum Clearance in Southern Province, Zambia

Author

Finn, Timothy P., primary, Porter, Travis R., additional, Moonga, Hawela, additional, Silumbe, Kafula, additional, Daniels, Rachel F., additional, Volkman, Sarah K., additional, Yukich, Joshua O., additional, Keating, Joseph, additional, Bennett, Adam, additional, Steketee, Richard W., additional, Miller, John M., additional, and Eisele, Thomas P., additional

Published
2020
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29. Evaluating the Impact of Programmatic Mass Drug Administration for Malaria in Zambia Using Routine Incidence Data

Author

Fraser, Maya, primary, Miller, John M, additional, Silumbe, Kafula, additional, Hainsworth, Michael, additional, Mudenda, Mutinta, additional, Hamainza, Busiku, additional, Moonga, Hawela, additional, Chizema Kawesha, Elizabeth, additional, Mercer, Laina D, additional, Bennett, Adam, additional, Schneider, Kammerle, additional, Slater, Hannah C, additional, Eisele, Thomas P, additional, and Guinovart, Caterina, additional

Published
2020
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30. Community-led Responses for Elimination (CoRE): a study protocol for a community randomized controlled trial assessing the effectiveness of community-level, reactive focal drug administration for reducing Plasmodium falciparum infection prevalence and incidence in Southern Province, Zambia

Author

Bridges, Daniel J., Miller, John M., Chalwe, Victor, Moonga, Hawela, Hamainza, Busiku, Steketee, Rick, Silumbe, Kafula, Nyangu, Jenala, and Larsen, David A.

Subjects
Adult, Male, Time Factors, Adolescent, Plasmodium falciparum, Zambia, Drug Administration Schedule, Study Protocol, Antimalarials, Young Adult, Clinical Protocols, Risk Factors, Prevalence, Humans, Community Health Services, Malaria, Falciparum, Child, Fluorenes, lcsh:R5-920, Incidence, Artemether, Lumefantrine Drug Combination, Infant, Middle Aged, Artemisinins, Drug Combinations, Treatment Outcome, Ethanolamines, Research Design, Child, Preschool, Quinolines, Female, lcsh:Medicine (General)
Abstract

Background Zambia is pushing for, and has made great strides towards, the elimination of malaria transmission in Southern Province. Reactive focal test and treat (RFTAT) using rapid diagnostic tests and artemether-lumefantrine (AL) has been key in making this progress. Reactive focal drug administration (RFDA) using dihydroartemisinin-piperaquine (DHAP), may be superior in accelerating clearance of the parasite reservoir in humans due to the provision of enhanced chemoprophylactic protection of at-risk populations against new infections. The primary aim of this study is to quantify the relative effectiveness of RFDA with DHAP against RFTAT with AL (standard of care) for reducing Plasmodium falciparum prevalence and incidence. Methods/design The study will be conducted in four districts in Southern Province, Zambia; an area of low malaria transmission and high coverage of vector control. A community randomized controlled trial of 16 health facility catchment areas will be used to evaluate the impact of sustained year-round routine RFDA for 2 years, relative to a control of year-round routine RFTAT. Reactive case detection will be triggered by a confirmed malaria case, e.g., by microscopy or rapid diagnostic test at any government health facility. Reactive responses will be performed by community health workers (CHW) within 7 days of the index case confirmation date. Responses will be performed out to a radius of 140 m from the index case household. A subset of responses will be followed longitudinally for 90 days to examine reinfection rates. Primary outcomes include a post-intervention survey of malaria seropositivity (n = 4800 children aged 1 month to under 5 years old) and a difference-in-differences analysis of malaria parasite incidence, as measured through routine passive case detection at health facilities enrolled in the study. The study is powered to detect approximately a 65% relative reduction in these outcomes between the intervention versus the control. Discussion Strengths of this trial include a robust study design and an endline cross-sectional parasite survey as well as a longitudinal sample. Primary limitations include statistical power to detect only a 65% reduction in primary outcomes, and the potential for contamination to dilute the effects of the intervention. Trial registration ClinicalTrials.gov, ID: NCT02654912. Registered on 12 November 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2249-0) contains supplementary material, which is available to authorized users.

Published
2017
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31. Measuring coverage in MNCH: accuracy of measuring diagnosis and treatment of childhood malaria from household surveys in Zambia

Author

Eisele, Thomas P., Silumbe, Kafula, Yukich, Josh, Hamainza, Busiku, Keating, Joseph, Bennett, Adam, and Miller, John M.

Subjects
Health promotion -- Management, Malaria -- Care and treatment -- Diagnosis, Children -- Health aspects, Company business management, Biological sciences
Abstract

Background: To assess progress in the scale-up of rapid diagnostic tests and artemisinin-based combination therapies (ACTs) across Africa, malaria control programs have increasingly relied on standardized national household surveys to determine the proportion of children with a fever in the past 2 wk who received an effective antimalarial within 1-2 d of the onset of fever. Here, the validity of caregiver recall for measuring the primary coverage indicators for malaria diagnosis and treatment of children Methods and Findings: A cross-sectional study was conducted in five public clinics in Kaoma District, Western Provence, Zambia, to estimate the sensitivity, specificity, and accuracy of caregivers' recall of malaria testing, diagnosis, and treatment, compared to a gold standard of direct observation at the health clinics. Compared to the gold standard of clinic observation, for recall for children with fever in the past 2 wk, the sensitivity for recalling that a finger/heel stick was done was 61.9%, with a specificity of 90.0%. The sensitivity and specificity of caregivers' recalling a positive malaria test result were 62.4% and 90.7%, respectively. The sensitivity and specificity of recalling that the child was given a malaria diagnosis, irrespective of whether a laboratory test was actually done, were 76.8% and 75.9%, respectively. The sensitivity and specificity for recalling that an ACT was given were 81.0% and 91.5%, respectively. Conclusions: Based on these findings, results from household surveys should continue to be used for ascertaining the coverage of children with a fever in the past 2 wk that received an ACT. However, as recall of a malaria diagnosis remains suboptimal, its use in defining malaria treatment coverage is not recommended. Please see later in the article for the Editors' Summary., Introduction New rapid diagnostic tests (RDTs) and artemisinin-based combination therapies (ACTs) are being scaled up across Africa in the fight against malaria [1,2]. Nearly all endemic countries in Africa have [...]

Published
2013
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32. Estimation of malaria parasite reservoir coverage using reactive case detection and active community fever screening from census data with rapid diagnostic tests in southern Zambia: a re-sampling approach

Author

Yukich, Joshua, primary, Bennett, Adam, additional, Yukich, Rudy, additional, Stuck, Logan, additional, Hamainza, Busiku, additional, Silumbe, Kafula, additional, Smith, Tom, additional, Chitnis, Nakul, additional, Steketee, Richard W., additional, Finn, Timothy, additional, Eisele, Thomas P., additional, and Miller, John M., additional

Published
2017
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35. Assessing the effectiveness of household-level focal mass drug administration and community-wide mass drug administration for reducing malaria parasite infection prevalence and incidence in Southern Province, Zambia: study protocol for a community randomized controlled trial

Author

Eisele, Thomas P., primary, Silumbe, Kafula, additional, Finn, Timothy, additional, Chalwe, Victor, additional, Kamuliwo, Mukalwa, additional, Hamainza, Busiku, additional, Moonga, Hawela, additional, Bennett, Adam, additional, Yukich, Josh, additional, Keating, Joseph, additional, Steketee, Richard W., additional, and Miller, John M., additional

Published
2015
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37. Population-Wide Malaria Testing and Treatment with Rapid Diagnostic Tests and Artemether-Lumefantrine in Southern Zambia: A Community Randomized Step-Wedge Control Trial Design

Author

Larsen, David A., primary, Bennett, Adam, additional, Silumbe, Kafula, additional, Hamainza, Busiku, additional, Yukich, Joshua O., additional, Keating, Joseph, additional, Littrell, Megan, additional, Miller, John M., additional, Steketee, Richard W., additional, and Eisele, Thomas P., additional

Published
2015
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38. A qualitative study of perceptions of a mass test and treat campaign in Southern Zambia and potential barriers to effectiveness

Author

Silumbe, Kafula, primary, Chiyende, Elizabeth, additional, Finn, Timothy P, additional, Desmond, Michelle, additional, Puta, Chilunga, additional, Hamainza, Busiku, additional, Kamuliwo, Mulakwa, additional, Larsen, David A, additional, Eisele, Thomas P, additional, Miller, John, additional, and Bennett, Adam, additional

Published
2015
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39. GENOMIC TOOLS REVEAL TRENDS IN PLASMODIUM FALCIPARUM PARASITE DIVERSITY ACROSS TRANSMISSION GRADIENTS WORLDWIDE

Author

Daniels, Rachel Fath, Deme, Awa B., Bei, Amy K., Bennett, Adam, Silumbe, Kafula, Chalwe, Victor, Kamuliwo, Mukalwa, Hamainza, Busiku, Yukich, Josh, Chizema, Elizabeth, Earle, Duncan, Huijben, Silvie, Aide, Pedro, Galatas, Beatriz, Lukens, Amanda K., Dondorp, Arjen M., Chang, Hsiao-Han, Eziefula, Alice, Tadesse, Fitsum G., Grignard, Lynn, Baro, Nicholas K., Morton, Lindsay, Charles, Macarthur, Vareta, Jimmy A., Ahmad, Rushdy, Taylor, Terrie E., Buckee, Caroline, Teun Bousema, Drakeley, Chris, Golightly, Linnie, Eisele, Thomas P., Steketee, Richard W., Miller, John M., Fairhurst, Rick M., Aponte, John, Alonso, Pedro L., Mayor, Alfredo, Milner, Danny A., Udhayakumar, Venkatachalam, Ndiaye, Daouda, Wirth, Dyann F., Hartl, Daniel L., and Volkman, Sarah K.

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