Investigation of P. Vivax Elimination via Mass Drug Administration

TL;DR

This study uses a stochastic multiscale model to evaluate the effectiveness of multiple rounds of mass drug administration with radical cure in eliminating P. vivax malaria, emphasizing the importance of accounting for hypnozoite dynamics and stochastic effects.

Contribution

It introduces a stochastic multiscale model that incorporates hypnozoite dynamics and superinfection to assess MDA strategies for P. vivax elimination.

Findings

Multiple rounds of high-efficacy MDA increase elimination probability.

Stochastic effects significantly influence elimination outcomes.

Targeting hypnozoites is crucial for successful P. vivax eradication.

Abstract

Plasmodium vivax is the most geographically widespread malaria parasite due to its ability to remain dormant (as a hypnozoite) in the human liver and subsequently reactivate. Given the majority of P. vivax infections are due to hypnozoite reactivation, targeting the hypnozoite reservoir with a radical cure is crucial for achieving P. vivax elimination. Stochastic effects can strongly influence dynamics when disease prevalence is low or when the population size is small. Hence, it is important to account for this when modelling malaria elimination.cWe use a stochastic multiscale model of P. vivax transmission to study the impacts of multiple rounds of mass drug administration (MDA) with a radical cure, accounting for superinfection and hypnozoite dynamics. Our results indicate multiple rounds of MDA with a high-efficacy drug are needed to achieve a substantial probability of elimination. This work has the potential to help guide P. vivax elimination strategies by quantifying elimination probabilities for an MDA approach.