Nav: Home

MDA associated with the prevention of a resurgence of malaria in Greece

November 19, 2015

Greece was declared malaria free in 1974, however, in 2011 a resurgence of P. vivax malaria was seen in Southern Greece in connection with the presence of agricultural workers from malaria-endemic regions in malaria receptive areas. Standard control measures were implemented for one year (i.e. Active case detection, intensifies vector control), after which a program of mass drug administration (MDA) was implemented to provide the entire local immigrant population with a curative course of antimalarial drugs. No malaria cases were reported for the years 2013-2014, when the MDA was on-going.

Since 1974 with only a small and sporadic number of malaria cases have been reported in Greece. However in 2011, 21 P. vivax cases from arriving immigrants were reported in the Southern agricultural area of Evrotas, along with 36 local cases. An integrated control program was immediately implemented, with house visits established to screen immigrants from endemic countries. Screening included a rapid diagnostic test for those reporting compatible symptoms along with blood sampling for smear and molecular testing for malaria. Directly Observed treatment was provided for all who tested positive. A vector control program was also implemented, with indoor residual spraying and long-lasting insecticide nets provided in areas close to mosquito breeding sites.

Despite these interventions 20 more introduced cases were reported in 2012 and, due to fears that the malaria parasite may be re-establishing in the area, a program of mass drug administration of one course of chloroquine and primaquine, which are the first line recommended antimalarials for P. vivax. Adverse events were recorded and managed daily. The program was implemented prior to the onset of peak adult mosquito activity and field teams remained in situ continuing the Active Case Detection until the end of the mosquito season.

An immigrant population of 1270 persons was identified, mostly from Pakistan and Afghanistan. MDA covered 87% of this population. Of the treated individuals 13% reported gastrointestinal symptoms from primaquine, while 36% reported non-severe side effects from chloroquine including headaches, dizziness and gastrointestinal complaints. One potentially serious adverse event was recorded; a case of primaquine-induced hemolysis due to a false normal G6PD level obtained prior to enrollment. The patient was hospitalized and recovered fully.

In this case, mass drug administration was a suitable and effective response for a small and geographically confined population over a short seasonal transition period. The combination of two drugs minimizes the risk of drug resistance. Although an observational study of this nature cannot assess the extent to which mass drug administration was responsible for eliminating malaria, it certainly indicates that mass drug administration should be considered and can be effective in local settings alongside other malaria control measures.
-end-
Please contact plosntds@plos.org if you would like more information about our content and specific topics of interest.

All works published in PLOS Neglected Tropical Diseases are open access, which means that everything is immediately and freely available. Use this URL in your coverage to provide readers access to the paper upon publication:

http://dx.plos.org/10.1371/journal.pntd.0004215 (Link goes live upon article publication)

Press-Only Preview Of The Article:https://www.plos.org/wp-content/uploads/2015/11/pntd.0004215.pdf

Contact: Christos Hadjichristodoulou, 0030 2410 565050, xhatzi@med.uth.gr

Funding: The data collected in the context of "Integrated Surveillance and control programme for West Nile Virus and malaria in Greece MIS 365280 (MALWEST Project )" which is implemented through the Operational Programme entitled "Human Resources Development" of National Strategic Reference Framework" (NSRF) 2007-2013. The programme is co-funded by Greece and the European Union--European Regional Development Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

About PLOS Neglected Tropical Diseases

PLOS Neglected Tropical Diseases is a peer-reviewed, open-access journal devoted to the pathology, epidemiology, prevention, treatment, and control of the neglected tropical diseases, as well as public policy relevant to this group of diseases. All works published in PLOS Neglected Tropical Diseases are open access, which means that everything is immediately and freely available subject only to the condition that the original authorship and source are properly attributed. The Public Library of Science uses the Creative Commons Attribution License, and copyright is retained by the authors.

About the Public Library of Science

The Public Library of Science (PLOS) is a non-profit organization of scientists and physicians committed to making the world's scientific and medical literature a freely available public resource. For more information, visit http://www.plos.org.

Media Permissions

PLOS Journals publish under a Creative Commons Attribution License, which permits free reuse of all materials published with the article, so long as the work is cited (e.g., Kaltenbach LS et al. (2007) Huntington Interacting Proteins Are Genetic Modifiers of Neurodegeneration. PLOS Genet 3(5): e82. doi:10.1371/journal.pgen.0030082). No prior permission is required from the authors or publisher. For queries about the license, please contact the relative journal contact indicated here: http://www.plos.org/journals/embargopolicy.php

PLOS

Related Malaria Articles:

Breakthrough in malaria research
An international scientific consortium led by the cell biologists Volker Heussler from the University of Bern and Oliver Billker from the Umeå University in Sweden has for the first time systematically investigated the genome of the malaria parasite Plasmodium throughout its life cycle in a large-scale experiment.
Scientists close in on malaria vaccine
Scientists have taken another big step forward towards developing a vaccine that's effective against the most severe forms of malaria.
New tool in fight against malaria
Modifying a class of molecules originally developed to treat the skin disease psoriasis could lead to a new malaria drug that is effective against malaria parasites resistant to currently available drugs.
Malaria expert warns of need for malaria drug to treat severe cases in US
The US each year sees more than 1,500 cases of malaria, and currently there is limited access to an intravenously administered (IV) drug needed for the more serious cases.
Monkey malaria breakthrough offers cure for relapsing malaria
A breakthrough in monkey malaria research by two University of Otago scientists could help scientists diagnose and treat a relapsing form of human malaria.
Getting to zero malaria cases in zanzibar
New research led by the Johns Hopkins Center for Communication Programs, Ifakara Health Institute and the Zanzibar Malaria Elimination Program suggests that a better understanding of human behavior at night -- when malaria mosquitoes are biting -- could be key to preventing lingering cases.
Widely used malaria treatment to prevent malaria in pregnant women
A global team of researchers, led by a research team at the Liverpool School of Tropical Medicine (LSTM), are calling for a review of drug-based strategies used to prevent malaria infections in pregnant women, in areas where there is widespread resistance to existing antimalarial medicines.
Protection against Malaria: A matter of balance
A balanced production of pro and anti-inflammatory cytokines at two years of age protects against clinical malaria in early childhood, according to a study led by ISGlobal, an institution supported by ''la Caixa'' Foundation.
The math of malaria
A new mathematical model for malaria shows how competition between parasite strains within a human host reduces the odds of drug resistance developing in a high-transmission setting.
Free malaria tests coupled with diagnosis-dependent vouchers for over-the-counter malaria treatment
Coupling free diagnostic tests for malaria with discounts on artemisinin combination therapy (ACT) when malaria is diagnosed can improve the rational use of ACTs and boost testing rates, according to a cluster-randomized trial published this week in PLOS Medicine by Wendy Prudhomme O'Meara of Duke University, USA, and colleagues.
More Malaria News and Malaria Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Climate Mindset
In the past few months, human beings have come together to fight a global threat. This hour, TED speakers explore how our response can be the catalyst to fight another global crisis: climate change. Guests include political strategist Tom Rivett-Carnac, diplomat Christiana Figueres, climate justice activist Xiye Bastida, and writer, illustrator, and artist Oliver Jeffers.
Now Playing: Science for the People

#562 Superbug to Bedside
By now we're all good and scared about antibiotic resistance, one of the many things coming to get us all. But there's good news, sort of. News antibiotics are coming out! How do they get tested? What does that kind of a trial look like and how does it happen? Host Bethany Brookeshire talks with Matt McCarthy, author of "Superbugs: The Race to Stop an Epidemic", about the ins and outs of testing a new antibiotic in the hospital.
Now Playing: Radiolab

Speedy Beet
There are few musical moments more well-worn than the first four notes of Beethoven's Fifth Symphony. But in this short, we find out that Beethoven might have made a last-ditch effort to keep his music from ever feeling familiar, to keep pushing his listeners to a kind of psychological limit. Big thanks to our Brooklyn Philharmonic musicians: Deborah Buck and Suzy Perelman on violin, Arash Amini on cello, and Ah Ling Neu on viola. And check out The First Four Notes, Matthew Guerrieri's book on Beethoven's Fifth. Support Radiolab today at Radiolab.org/donate.