Advances 4: Mass treatment as a malaria elimination accelerator
Where malaria transmission is low the prospects for elimination increase. In the Greater Mekong subregion (GMS), which harbours the most drug resistant P. falciparum in the world, there is a general consensus that the only way to counter multi-drug resistance effectively is to eliminate all falciparum malaria. This is an area of low seasonal malaria transmission and targeted malaria elimination, even in the most remote and inaccessible areas, has been very effective (34, 35). The key to successful elimination is the support of village health workers in every village (usually 300-800 people) to provide diagnosis of malaria with a rapid diagnostic test, and treatment with an effective ACT (36). In foci of higher transmission (sometimes called “hot spots’), where a significant proportion of the healthy population have asymptomatic parasitaemias, mass treatments with dihydroartemisinin-piperaquine have proved very effective and well tolerated “accelerators” of elimination (34,35).