Prevalence of asymptomatic malaria parasitaemia following mass testing and treatment in Pakro sub-district of Ghana
Date
2019-12-03
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Public Health
Abstract
Background: Global efforts to scale-up malaria control interventions are gaining steam. These include the use of
Long-Lasting Insecticide Nets, Indoor Residual Spraying, Intermittent Preventive Treatment and Test, Treat and Track.
Despite these, the drive for malaria elimination is far from being realistic in endemic communities in Africa. This is
partly due to the fact that asymptomatic parasite carriage, not specifically targeted by most interventions, remains
the bedrock that fuels transmission. This has led to mass testing, treatment and tracking (MTTT) as an alternative
strategy to target asymptomatic individuals. We report the impact of MTTT on the prevalence of asymptomatic
malaria parasitaemia over a one-year period in Ghana, hypothesizing that implementing MTTT could reduce the
rate of asymptomatic parasitaemia.
Methods: A population of about 5000 individuals in seven communities in the Pakro sub-district of Ghana participated
in this study. A register was developed for each community following a census. MTTT engaged trained communitybased
health volunteers who conducted house-to-house testing using RDTs every 4 months and treated positive cases
with Artemisinin–based Combination Therapy. Between interventions, community-based management of malaria was
implemented for symptomatic cases.
Results: MTTT Coverage was 98.8% in July 2017 and 79.3% in July 2018. Of those tested, asymptomatic infection with
malaria parasites reduced from 36.3% (1795/4941) in July 2017 to 32.9% (1303/3966) in July 2018 (p = 0.001). Prevalence
of asymptomatic parasitaemia among children under 15 years declined from 52.6% (1043/1984) in July 2017 to 47.5%
(820/1728) in July 2018 (p = 0.002). Implementing MTTT significantly reduced asymptomatic parasitaemia by 24% from
July 2017 to July 2018 after adjusting for age, ITN use and axillary temperature (OR = 0.76, CI = 0.67, 0.85 p ≤ 0.001).
Conclusion: This study has demonstrated that implementing MTTT is feasible and could reduce the prevalence of
asymptomatic malaria parasitaemia in children under 15 years of age. Furthermore, the use of community-based health
volunteers could ensure high coverage at lower cost of implementation.
Description
Research Article
Keywords
malaria control interventions, Long-Lasting Insecticide Nets, Treat and Track, Africa