An Innovative Evaluation of Mass Drug Administration with Primaquine in Iran

Abstract

Background: A key strategy in the global fight against malaria, endorsed by the World Health Organization (WHO), is mass drug administration (MDA). Evaluating the impact of this initiative on malaria transmission reduction is crucial. Objectives: This study aimed to assess the effectiveness of MDA combined with primaquine (PQ) in the southern Iranian region of Jask, specifically in Lirdaf. Methods: Primaquine was chosen as the antimalarial drug for this intervention. A total of 168 Pakistani individuals receiving MDA were evaluated over an eight-week period from September to December 2021. Results: Three cases of vivax malaria were identified. Among the 168 patients receiving PQ, 26 were found to have a deficiency in the enzyme glucose-6-phosphate dehydrogenase (G6PD), leading to the exclusion of thirty participants from the trial. Additionally, three individuals were withdrawn from the project due to restricted access (two cases) and family-related issues (one case). One participant, initially asymptomatic and positive, later tested positive again, and this case was excluded from the analysis. Regular follow-up assessments were conducted on all participants, revealing no cases of relapse throughout the project duration. Conclusions: Our findings suggest that employing MDA in combination with supplementary interventions during the elimination phase holds promise for malaria control efforts.