Evaluating the Impact of Pilot Mass Drug Administration against Malaria in Two Hyper-endemic Districs in Papua Province Indonesia (MOMAL)

Funder
UNICEF Indonesia

OUCRU Investigators
Lenny L. Ekawati
Dr Iqbal Elyazar
Adhi Andrianto

External Investigators
Dr. Hellen Prameswari
Dr. Minerva Theodora
Deddy Supriyanto
Silas Mabui
Irawan, MPH
Anastasiah, MPH
Dr. Herdiana Basri
Dr. Ermi Ndoen

Location
Greater Jakarta

Duration
2020-2023

This study evaluates the impact of a mass drug administration (MDA) pilot program to control malaria in two districts in Papua, Indonesia, where malaria cases are extremely high.

Background 

Despite years of malaria control efforts, Papua remains the most affected area in Indonesia, with up to 90% of national malaria cases reported here. This has prompted the National Malaria Control Program (NMCP) to explore mass drug administration (MDA) as an intervention. MDA involves giving antimalarial drugs to entire populations in targeted areas to reduce transmission quickly. NMCP ran the first MDA pilot in two highly affected districts of Papua, covering 7,000 people. The aim of this evaluation is to determine the effectiveness of MDA in reducing malaria cases and understand any challenges in implementation.

 Study Design

The study analyzes data collected during the MDA pilot. The intervention consists of three phases:

  1. Pre-MDA Phase: Data on malaria cases were collected 12 months before the MDA started.
  2. MDA Phase: Three rounds of MDA were conducted, with data on demographics, dosing, and adverse events collected.
  3. Post-MDA Phase: Malaria case data were gathered for four months after the MDA.

Goal

  • Primary Objective:
    To assess whether three rounds of MDA with DHA-PPQ (an antimalarial drug) can reduce the number of malaria cases, especially for P. falciparum malaria (the most dangerous strain).
  • Secondary Objectives:
    To assess the impact on other types of malaria, evaluate any side effects of the treatment, and understand how the public responds to the MDA intervention.

The study uses interrupted time-series analysis to assess the impact of MDA over time. A control group (villages not receiving MDA) is also being considered to compare results.

Status

As of the end of 2023, the final MDA round has been completed. Analysis is ongoing.

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