"Identify and treat" method of malaria lowers disease's prevalence

A new study by the Johns Hopkins Malaria Research Institute has determined that a strategy of actively identifying malaria that has gone undiagnosed and treating those with the disease resulted in lower malaria prevalence.

The study, conducted in southern Zambia, analyzed data from surveys in 2007 and between 2008 and 2009. The surveys used rapid diagnostic tests to screen households for malaria and treated those who had malaria with artemisinin combination therapy.

"New strategies are needed, particularly in areas of declining transmission," Catherine G. Sutcliffe, the study's lead author, said." One strategy is to screen people for malaria and treat those who are infected, even those who are not sick enough to go to the clinic. Using artemisinin combination therapy can enhance this strategy, as treatment can reduce transmission to mosquitoes. In regions of declining transmission, the burden of malaria could be reduced to such an extent that elimination is achievable."

Using a proactive test-and-treat strategy of case detection led to a six-fold reduction in malaria case prevalence in 2008 and 2009 and a two-fold reduction in 2007. Asymptomatic or minimally symptomatic malaria can be as high as 35 percent in some malaria endemic populations. Those who are without symptoms can become reservoirs for spreading the disease even when its numbers are on the decline.

"Proactive case detection with treatment using artemisinin-combination therapy can reduce transmission and provide indirect protection to household members," William J. Moss, the senior author of the study, said. "If resources permit, this strategy could be targeted to hot spots to achieve further reductions in malaria transmission."

Malaria kills between 800,000 and one million people every year, many of whom are African children.