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Quantifying Plasmodium falciparum infections clustering within households to inform household-based intervention strategies for malaria control programs: An observational study and meta-analysis from 41 malaria-endemic countries

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  • Gillian Stresman
  • Charlie Whittaker
  • Hannah C Slater
  • Teun Bousema
  • Jackie Cook

Abstract

Background: Reactive malaria strategies are predicated on the assumption that individuals infected with malaria are clustered within households or neighbourhoods. Despite the widespread programmatic implementation of reactive strategies, little empirical evidence exists as to whether such strategies are appropriate and, if so, how they should be most effectively implemented. Methods and findings: We collated 2 different datasets to assess clustering of malaria infections within households: (i) demographic health survey (DHS) data, integrating household information and patent malaria infection, recent fever, and recent treatment status in children; and (ii) data from cross-sectional and reactive detection studies containing information on the household and malaria infection status (patent and subpatent) of all-aged individuals. Both datasets were used to assess the odds of infections clustering within index households, where index households were defined based on whether they contained infections detectable through one of 3 programmatic strategies: (a) Reactive Case Detection (RACD) classifed by confirmed clinical cases, (b) Mass Screen and Treat (MSAT) classifed by febrile, symptomatic infections, and (c) Mass Test and Treat (MTAT) classifed by infections detectable using routine diagnostics. Data included 59,050 infections in 208,140 children under 7 years old (median age = 2 years, minimum = 2, maximum = 7) by microscopy/rapid diagnostic test (RDT) from 57 DHSs conducted between November 2006 and December 2018 from 23 African countries. Data representing 11,349 infections across all ages (median age = 22 years, minimum = 0.5, maximum = 100) detected by molecular tools in 132,590 individuals in 43 studies published between April 2006 and May 2019 in 20 African, American, Asian, and Middle Eastern countries were obtained from the published literature. Extensive clustering was observed—overall, there was a 20.40 greater (95% credible interval [CrI] 0.35–20.45; P

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  • Gillian Stresman & Charlie Whittaker & Hannah C Slater & Teun Bousema & Jackie Cook, 2020. "Quantifying Plasmodium falciparum infections clustering within households to inform household-based intervention strategies for malaria control programs: An observational study and meta-analysis from ," PLOS Medicine, Public Library of Science, vol. 17(10), pages 1-17, October.
    • Handle: RePEc:plo:pmed00:1003370
    DOI: 10.1371/journal.pmed.1003370
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    2. Bronner P. Gonçalves & Melissa C. Kapulu & Patrick Sawa & Wamdaogo M. Guelbéogo & Alfred B. Tiono & Lynn Grignard & Will Stone & Joel Hellewell & Kjerstin Lanke & Guido J. H. Bastiaens & John Bradley , 2017. "Examining the human infectious reservoir for Plasmodium falciparum malaria in areas of differing transmission intensity," Nature Communications, Nature, vol. 8(1), pages 1-11, December.
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    1. Fitzpatrick, Anne, 2022. "The impact of public health sector stockouts on private sector prices and access to healthcare: Evidence from the anti-malarial drug market," Journal of Health Economics, Elsevier, vol. 81(C).
    2. Olukunle O. Oyegoke & Olusegun P. Akoniyon & Ropo E. Ogunsakin & Michael O. Ogunlana & Matthew A. Adeleke & Rajendra Maharaj & Moses Okpeku, 2022. "A Systematic Review and Meta-Analysis of Malaria Test Positivity Outcomes and Programme Interventions in Low Transmission Settings in Southern Africa, 2000–2021," IJERPH, MDPI, vol. 19(11), pages 1-17, June.

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