Gerardin Jaline, Bertozzi-Villa Amelia, Eckhoff Philip A, Wenger Edward A
Institute for Disease Modeling, Bellevue, WA, USA.
Int Health. 2018 Jul 1;10(4):252-257. doi: 10.1093/inthealth/ihy025.
Mass drug administration (MDA) is a control and elimination tool for treating infectious diseases. For malaria, it is widely accepted that conducting MDA during the dry season results in the best outcomes. However, seasonal movement of populations into and out of MDA target areas is common in many places and could potentially fundamentally limit the ability of MDA campaigns to achieve elimination.
A mathematical model was used to simulate malaria transmission in two villages connected to a high-risk area into and out of which 10% of villagers traveled seasonally. MDA was given only in the villages. Prevalence reduction under various possible timings of MDA and seasonal travel was predicted.
MDA is most successful when distributed outside the traveling season and during the village low-transmission season. MDA is least successful when distributed during the traveling season and when traveling overlaps with the peak transmission season in the high-risk area. Mistiming MDA relative to seasonal travel resulted in much poorer outcomes than mistiming MDA relative to the peak transmission season within the villages.
Seasonal movement patterns of high-risk groups should be taken into consideration when selecting the optimum timing of MDA campaigns.
群体药物给药（MDA）是治疗传染病的一种控制和消除手段。对于疟疾而言，人们普遍认为在旱季开展群体药物给药能取得最佳效果。然而，在许多地方，人群季节性进出群体药物给药目标地区的情况很常见，这可能会从根本上限制群体药物给药活动实现消除疟疾的能力。
使用数学模型模拟两个与高风险地区相连的村庄的疟疾传播情况，10%的村民会季节性进出这两个村庄。仅在这两个村庄进行群体药物给药。预测了在群体药物给药和季节性出行的各种可能时间安排下的患病率降低情况。
在出行季节之外且村庄处于低传播季节时进行群体药物给药最为成功。在出行季节进行群体药物给药以及出行与高风险地区的传播高峰期重叠时，群体药物给药最不成功。与季节性出行相比，群体药物给药时间安排不当导致的结果比在村庄内与传播高峰期时间安排不当导致的结果差得多。
在选择群体药物给药活动的最佳时间时，应考虑高风险群体的季节性流动模式。
