Fast Elimination of Malaria by Source Eradication (FEMSE) Project
To investigate the therapeutic effect of the method of Fast Elimination of Malaria by Source Eradication (FEMSE), through Mass Drug Administration (MDA) campaigns in Anjouan Island (2012) and Grande Comore Island (2013).
Secondary objectives in Anjouan Island:
- To investigate whether 3 monthly rounds of MDA regimens of ACT (Artemisinin–piperaquine), with or without low-dose primaquine can quickly block malaria transmission in Anjouan Island
- To investigate whether MDA regimens of ACT, with or without low-dose primaquine can increase or decrease the risk of drug resistance
- To examine how the benefits of the individual drugs (low-dose primaquine) balance against the liabilities of their use and attendant possibilities of adverse events, including the risks and contraindications of primaquine in conditions of G6PD-deficiency and early pregnancy
- To investigate in which settings can the inclusion of low-dose primaquine as a gametocidal drug improve MDA outcomes
Secondary objectives in Grande Comore Island:
- To investigate whether MDA regimens of ACT (Artemisinin–piperaquine) can quickly block malaria transmission in Grande Comore Island
- To examine whether MDA regimens of ACT can increase or decrease the risk of drug resistance in Grande Comore Island
Artemisinin–piperaquine, with or without Primaquine, was administered in 3 monthly rounds from October to December 2012 across Anjouan Island, Union of Comoros. Plasmodium falciparum malaria rates, mortality, parasitemias, adverse events, and PfK13 Kelch-propeller gene polymorphisms were evaluated.
The concomitant interventions deployed were LLINs, IRS, IPTp, and medical care for malaria (If infected with P. falciparum malaria, pregnant women within 3 months of conception received quinine or piperaquine orally, children < six months old took AP orally, and patients with chronic liver or kidney diseases were treated with quinine by intravenous drip according to the guidelines of the Comoros Ministry of Health).
Steep reductions of malaria cases were achieved suggesting the potential for highly successful MDA in epidemiological settings such as those on Anjouan. A major challenge is to sustain and expand the public health benefits of malaria reductions by MDA.
In Grande Comore Island, 3 monthly rounds of Artemisinin-Piperaquine were deployed from October to December 2013. Plasmodium falciparum malaria rates, mortality, parasitemias, adverse events, and PfK13 Kelch-propeller gene polymorphisms were evaluated.
The concomitant interventions were LLINs, IRS, systematic testing for malaria before the treatment and intensified surveillance.
Intervention model: Single group
Masking: None (open label)
Primary purpose: Treatment