Mass Drug Administration for Malaria Elimination

This study used a cross-sectional mixed-methods approach (including both quantitative and qualitative components). The study was conducted in 7 malaria endemic villages; 2 villages were selected in Narathiwat Province and 5 villages were selected from Yala Province (Fig. 1), both provinces in malaria endemic Southern Thailand which borders Malaysia. In 2019, total malaria cases in Yala and Narathiwat provinces were 1,368 and 70 cases, respectively. P. vivax in this region is widespread and there are concerns about chloroquine and antifolate resistant P. vivax malaria and artemisinin resistant P. falciparum malaria [25 (link)].Fig. 1

Study sites in Yala and Narathiwat Provinces of Southern Thailand

The MDA with PQ was implemented in all of 7 study villages using a step-wedge approach. The MDA was done using a low dose of primaquine (0.25 mg/kg) over 14 days, with direct observation. All individuals were tested for G6PD deficiency. G6PD deficient individuals; children < 7 or anyone weight < 15 kg; anemic individuals (with hemoglobin level < 8 g/dL); pregnant or lactating women; and anyone who self-reported previous adverse symptoms from taking primaquine were excluded from the MDA. The first round of MDA with primaquine was done in September 2019 and a second round was done in August 2020. Detailed results from the MDA will be reported elsewhere.