Pilot Study On Fast Control Malaria In A Highly Endemic Area Of Cambodia

Previous efforts to eradicate malaria parasites, particularly Plasmodium falciparum, have failed due mainly to the emergence of drug resistant parasites and mosquitoes resistant to insecticides. With the development of new combination drugs that can kill the parasites quickly, we have designed a strategy to eliminate the source of transmission by mass treatment of human populations in malaria endemic areas in Kampong Speu province, Cambodia. Artequick, a combination drug containing artemisinin and piperaquine, and low dose primaquine were used to eliminate all stages of parasites from human positives. In the first pilot study, mass administration of artemisinin plus piperaquine (2 tablets at 0 and 24 hrs) and primaquine (9mg, at 10 day intervals for 6 months) to general populations in 17 villages (3,653 individuals) dramatically reduced the average malaria parasite rates in children from 55.8% to 2.8% three years from the start of the program, including to 0% in eight villages. The P. falciparum rate in children fell from 37.0% to 1.4%,. In the second study, in which one additional mass treatment was given 42 days after the first, the P. falciparum rate in children fell from 20.8% to 0% within six months. Mass administration of artemisinin plus piperaquine and primaquine is an effective, safe, and affordable method for eradicating or dramatically reducing the prevalence of malaria parasites in endemic regions.