Evaluating programmatic reactive focal drug administration impact on malaria incidence in northern Senegal: an interrupted time series analysis
Abstract Background The World Health Organization conditionally recommends reactive drug administration to reduce malaria transmission in settings approaching elimination. However, few studies have evaluated the impact of reactive focal drug administration (rFDA) in sub-Saharan Africa, and none have...
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2025-01-01
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| Series: | Malaria Journal |
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| Online Access: | https://doi.org/10.1186/s12936-025-05245-5 |
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| author | Ellen Leah Ferriss Yakou Dieye Moustapha Cissé Gnagna Dieng Sow Jean Louis Lankia Damien Diedhiou Abiboulaye Sall Tamba Souane Tidiane Thiam Doudou Sene Elhadji Doucouré Ibrahima Diallo Adam Bennett Caterina Guinovart |
| author_facet | Ellen Leah Ferriss Yakou Dieye Moustapha Cissé Gnagna Dieng Sow Jean Louis Lankia Damien Diedhiou Abiboulaye Sall Tamba Souane Tidiane Thiam Doudou Sene Elhadji Doucouré Ibrahima Diallo Adam Bennett Caterina Guinovart |
| author_sort | Ellen Leah Ferriss |
| collection | DOAJ |
| description | Abstract Background The World Health Organization conditionally recommends reactive drug administration to reduce malaria transmission in settings approaching elimination. However, few studies have evaluated the impact of reactive focal drug administration (rFDA) in sub-Saharan Africa, and none have evaluated it under programmatic conditions. In 2016, Senegal’s national malaria control programme introduced rFDA, the presumptive treatment of compound members of a person with confirmed malaria, and reactive mass focal drug administration (rMFDA), an expanded effort including neighbouring compounds during an outbreak, in 10 low transmission districts in the north of the country. This evaluation sought to measure the impact of rFDA and rMFDA on malaria incidence. Methods An interrupted time series analysis was conducted with routine surveillance data on health post-level monthly confirmed malaria case counts from the District Health Information Software (DHIS2). The study evaluated the change in incidence following rFDA and rMFDA rollout (level change), which ranged from August 2016 to November 2019, and monthly thereafter (trend change), using an adjusted negative binomial regression model with data from January 2015 through January 2020. The model was used to estimate the number of cases averted via a counterfactual simulation. Results No incidence rate reductions were estimated immediately following rollout (level change: incidence rate ratio (IRR) = 1.00, 95% credible interval (CI) = 0.76, 1.33). However, rFDA and rMFDA were associated with a 4% monthly decline in incidence relative to the baseline trend (trend change: IRR = 0.96, 95% CI = 0.95, 0.98). Over the study period, RFDA and rMFDA were estimated to avert 2,070 (95% CI = 577, 4,367) of 4,108 (95% CI = 2,620, 6,425) malaria cases. Conclusions RFDA and rMFDA were associated with reduced malaria incidence in northern Senegal, supporting their use in malaria control in very low transmission areas. However, additional strategies are likely needed to achieve elimination in this setting. |
| format | Article |
| id | doaj-art-336f71108f2b41b782759ba321477a56 |
| institution | Kabale University |
| issn | 1475-2875 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | Malaria Journal |
| spelling | doaj-art-336f71108f2b41b782759ba321477a562025-01-26T12:15:54ZengBMCMalaria Journal1475-28752025-01-012411910.1186/s12936-025-05245-5Evaluating programmatic reactive focal drug administration impact on malaria incidence in northern Senegal: an interrupted time series analysisEllen Leah Ferriss0Yakou Dieye1Moustapha Cissé2Gnagna Dieng Sow3Jean Louis Lankia4Damien Diedhiou5Abiboulaye Sall6Tamba Souane7Tidiane Thiam8Doudou Sene9Elhadji Doucouré10Ibrahima Diallo11Adam Bennett12Caterina Guinovart13PATHPATHPATHPATHPATHPATHPATHPATHPATHProgramme National de Lutte contre le Paludisme, Ministère de la SantéProgramme National de Lutte contre le Paludisme, Ministère de la SantéProgramme National de Lutte contre le Paludisme, Ministère de la SantéPATHPATHAbstract Background The World Health Organization conditionally recommends reactive drug administration to reduce malaria transmission in settings approaching elimination. However, few studies have evaluated the impact of reactive focal drug administration (rFDA) in sub-Saharan Africa, and none have evaluated it under programmatic conditions. In 2016, Senegal’s national malaria control programme introduced rFDA, the presumptive treatment of compound members of a person with confirmed malaria, and reactive mass focal drug administration (rMFDA), an expanded effort including neighbouring compounds during an outbreak, in 10 low transmission districts in the north of the country. This evaluation sought to measure the impact of rFDA and rMFDA on malaria incidence. Methods An interrupted time series analysis was conducted with routine surveillance data on health post-level monthly confirmed malaria case counts from the District Health Information Software (DHIS2). The study evaluated the change in incidence following rFDA and rMFDA rollout (level change), which ranged from August 2016 to November 2019, and monthly thereafter (trend change), using an adjusted negative binomial regression model with data from January 2015 through January 2020. The model was used to estimate the number of cases averted via a counterfactual simulation. Results No incidence rate reductions were estimated immediately following rollout (level change: incidence rate ratio (IRR) = 1.00, 95% credible interval (CI) = 0.76, 1.33). However, rFDA and rMFDA were associated with a 4% monthly decline in incidence relative to the baseline trend (trend change: IRR = 0.96, 95% CI = 0.95, 0.98). Over the study period, RFDA and rMFDA were estimated to avert 2,070 (95% CI = 577, 4,367) of 4,108 (95% CI = 2,620, 6,425) malaria cases. Conclusions RFDA and rMFDA were associated with reduced malaria incidence in northern Senegal, supporting their use in malaria control in very low transmission areas. However, additional strategies are likely needed to achieve elimination in this setting.https://doi.org/10.1186/s12936-025-05245-5MalariaReactive focal drug administrationRFDAElimination |
| spellingShingle | Ellen Leah Ferriss Yakou Dieye Moustapha Cissé Gnagna Dieng Sow Jean Louis Lankia Damien Diedhiou Abiboulaye Sall Tamba Souane Tidiane Thiam Doudou Sene Elhadji Doucouré Ibrahima Diallo Adam Bennett Caterina Guinovart Evaluating programmatic reactive focal drug administration impact on malaria incidence in northern Senegal: an interrupted time series analysis Malaria Journal Malaria Reactive focal drug administration RFDA Elimination |
| title | Evaluating programmatic reactive focal drug administration impact on malaria incidence in northern Senegal: an interrupted time series analysis |
| title_full | Evaluating programmatic reactive focal drug administration impact on malaria incidence in northern Senegal: an interrupted time series analysis |
| title_fullStr | Evaluating programmatic reactive focal drug administration impact on malaria incidence in northern Senegal: an interrupted time series analysis |
| title_full_unstemmed | Evaluating programmatic reactive focal drug administration impact on malaria incidence in northern Senegal: an interrupted time series analysis |
| title_short | Evaluating programmatic reactive focal drug administration impact on malaria incidence in northern Senegal: an interrupted time series analysis |
| title_sort | evaluating programmatic reactive focal drug administration impact on malaria incidence in northern senegal an interrupted time series analysis |
| topic | Malaria Reactive focal drug administration RFDA Elimination |
| url | https://doi.org/10.1186/s12936-025-05245-5 |
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