Peto Thomas J, Tripura Rupam, Sanann Nou, Adhikari Bipin, Callery James, Droogleever Mark, Heng Chhouen, Cheah Phaik Yeong, Davoeung Chan, Nguon Chea, von Seidlein Lorenz, Dondorp Arjen M, Pell Christopher
Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
Trans R Soc Trop Med Hyg. 2018 Jun 1;112(6):264-271. doi: 10.1093/trstmh/try053.
Mass drug administrations (MDAs) are part of the World Health Organization's Plasmodium falciparum elimination strategy for the Greater Mekong Subregion (GMS). In Cambodia, a 2015-2017 clinical trial evaluated the effectiveness of MDA. This article explores factors that influence the feasibility and acceptability of MDA, including seasonal timing, financial incentives and the delivery model.
Quantitative data were collected through structured questionnaires from the heads of 163 households. Qualitative data were collected through 25 semi-structured interviews and 5 focus group discussions with villagers and local health staff. Calendars of village activities were created and meteorological and malaria treatment records were collected.
MDA delivered house-to-house or at a central point, with or without compensation, were equally acceptable and did not affect coverage. People who knew about the rationale for the MDA, asymptomatic infections and transmission were more likely to participate. In western Cambodia, MDA delivered house-to-house by volunteers at the end of the dry season may be most practicable but requires the subsequent treatment of in-migrants to prevent reintroduction of infections.
For MDA targeted at individual villages or village clusters it is important to understand local preferences for community mobilisation, delivery and timing, as several models of MDA are feasible.
群体药物给药（MDA）是世界卫生组织大湄公河次区域（GMS）恶性疟原虫消除战略的一部分。在柬埔寨，2015 - 2017年的一项临床试验评估了群体药物给药的有效性。本文探讨了影响群体药物给药可行性和可接受性的因素，包括季节时间、经济激励措施和给药模式。
通过结构化问卷从163户家庭户主处收集定量数据。通过与村民和当地卫生工作人员进行25次半结构化访谈和5次焦点小组讨论收集定性数据。创建了村庄活动日历，并收集了气象和疟疾治疗记录。
逐户或在中心点进行群体药物给药，无论有无补偿，其可接受程度相同，且不影响覆盖率。了解群体药物给药基本原理、无症状感染和传播情况的人更有可能参与。在柬埔寨西部，旱季末由志愿者逐户进行群体药物给药可能最为可行，但需要对迁入者进行后续治疗以防止感染重新传入。
对于针对单个村庄或村庄集群的群体药物给药，了解当地对社区动员、给药方式和时间的偏好很重要，因为有几种群体药物给药模式是可行的。
