Malaria is the most important mosquito-borne disease caused by a
parasite, accounting for an estimated 660,000 deaths annually.
Fortunately, malaria is both preventable and treatable. Several malaria
control tools currently exist, and new and innovative approaches are
continually under development.
The administration of drugs against malaria to whole populations, termed
mass drug administration (MDA), was a component of many malaria
elimination programmes in the 1950s, and is once again attracting
interest as a malaria elimination tool. As a consequence, it is
important to review the currently available literature in order to
assess the potential for this strategy to reduce malaria burden and
transmission, and to identify gaps in our understanding.
This review assessed the impact of MDA on several malaria-specific
outcome measures. Thirty-two studies were included in this review, from
sites in Asia, Africa, Europe and the Americas.
The review found that although MDA can reduce the initial risk of
malaria-specific outcomes, these reductions are often not sustained.
However, a few studies conducted on small islands or in highland areas
did show sustained impact more than six months after MDA.
Adverse events were inadequately addressed in most studies. Notable
severe drug reactions, including haemolysis, haemoglobinuria, severe
anaemia and death, were reported with 8-aminoquinoline plus
schizonticide drug co-administration, while severe skin reactions were
reported with sulphadoxine-pyrimethamine plus artesunate plus
Assessing the true impact of MDA programmes can be a challenge due to
the heterogeneity of the study methods employed. Nonetheless, this
review can help guide future antimalarial MDA interventions and their
Poirot, E.; Skarbinski, J.; Sinclair, D.; Kachur, S.P.; Slutsker, L.; Hwang, J. Mass drug administration for malaria. Cochrane Database of Systematic Reviews (2013) Issue 12, Art. No.: CD008846. [DOI: 10.1002/14651858.CD008846.pub2]
Mass drug administration for malaria