Testing and treatment for malaria elimination: a systematic review

Gretchen Newby; Chris Cotter; Michelle E Roh; Kelly Harvard; Adam Bennett; Jimee Hwang; Nakul Chitnis; Sydney Fine; Gillian Stresman; Ingrid Chen; Roly Gosling; Michelle S Hsiang

doi:10.1186/s12936-023-04670-8

Testing and treatment for malaria elimination: a systematic review

Malar J. 2023 Sep 3;22(1):254. doi: 10.1186/s12936-023-04670-8.

Authors

Gretchen Newby¹, Chris Cotter^{1

2}, Michelle E Roh^{1

3}, Kelly Harvard¹, Adam Bennett^{1

3

4}, Jimee Hwang⁵, Nakul Chitnis^{6

7}, Sydney Fine¹, Gillian Stresman^{8

9}, Ingrid Chen^{1

3}, Roly Gosling^{1

3

10}, Michelle S Hsiang^{11

12

13}

Affiliations

¹ Malaria Elimination Initiative, Institute for Global Health Sciences, University of California San Francisco (UCSF), 550 16th Street, San Francisco, CA, 94143, USA.
² Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
³ Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA.
⁴ PATH, Seattle, WA, USA.
⁵ Malaria Branch, Centers for Disease Control and Prevention, U.S. President's Malaria Initiative, Atlanta, GA, USA.
⁶ Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
⁷ University of Basel, Basel, Switzerland.
⁸ College of Public Health, University of South Florida, Tampa, FL, USA.
⁹ Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK.
¹⁰ Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
¹¹ Malaria Elimination Initiative, Institute for Global Health Sciences, University of California San Francisco (UCSF), 550 16th Street, San Francisco, CA, 94143, USA. michelle.hsiang@ucsf.edu.
¹² Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA. michelle.hsiang@ucsf.edu.
¹³ Department of Pediatrics, UCSF, San Francisco, CA, USA. michelle.hsiang@ucsf.edu.

Abstract

Background: Global interest in malaria elimination has prompted research on active test and treat (TaT) strategies.

Methods: A systematic review and meta-analysis were conducted to assess the effectiveness of TaT strategies to reduce malaria transmission.

Results: A total of 72 empirical research and 24 modelling studies were identified, mainly focused on proactive mass TaT (MTaT) and reactive case detection (RACD) in higher and lower transmission settings, respectively. Ten intervention studies compared MTaT to no MTaT and the evidence for impact on malaria incidence was weak. No intervention studies compared RACD to no RACD. Compared to passive case detection (PCD) alone, PCD + RACD using standard diagnostics increased infection detection 52.7% and 11.3% in low and very low transmission settings, respectively. Using molecular methods increased this detection of infections by 1.4- and 1.1-fold, respectively.

Conclusion: Results suggest MTaT is not effective for reducing transmission. By increasing case detection, surveillance data provided by RACD may indirectly reduce transmission by informing coordinated responses of intervention targeting.

Keywords: Active case detection; Malaria; Malaria elimination; Plasmodium falciparum; Proactive; Reactive; Screen and treat; Test and treat.

Publication types

Systematic Review
Meta-Analysis
Review

MeSH terms

Humans
Malaria* / diagnosis
Malaria* / drug therapy
Malaria* / prevention & control

Grants and funding

OPP1160129/Bill and Melinda Gates Foundation