THE ADAM PROJECT CARRIES OUT REACTIVE FOCAL DRUG ADMINISTRATION AGAINST MALARIA IN MATUTUINE

The initiative consists in identifying all malaria cases and administering antimalarials to all their household members.

After implementing two rounds of Mass Drug Administration (MDA) against malaria in the administrative post of Chidenguele (Manjacaze district, in Gaza province) in December 2022 and January/February 2023, the ADAM project is now implementing reactive Focal Drug Administration (rFDA) in Matutuine district, in Maputo province, since April of this year. The rFDA strategy consists in the passive identification of all malaria cases (considered "index cases") diagnosed at health facilities or by Community Health Workers (CHWs) and a subsequent visit to their households, where all eligible members who consent are treated with the antimalarial drug (dihydroartemisinin-piperaquine - DHAp), regardless of their infection status.

This initiative is implemented in the context of the ADAM Project, which aims to generate data for the National Malaria Control Program (NMCP) through piloting and evaluating the programmatic implementation of the MDA and rFDA.

To evaluate the implementation of the rFDA, the project, financed by the European and Developing Countries Clinical Trials Partnership (EDCTP), is conducting a cross-sectional community survey to 208 randomly selected families (households), with the aim of evaluating the feasibility of implementing this intervention through the country's health system.

We hope there will be a reduction in malaria transmission rates

“After having massively administered drugs (Dihydroartemisinin Piperaquine – DHAp) against malaria to all residents with inclusion criteria in an area of moderate transmission (Chidenguele), , we hope that the transmission of malaria and the number of cases observed before administration will reduce. We have now moved to the Matutuine district, which has low transmission and the characteristics of an area in the phase of malaria elimination, to evaluate how we can improve the implementation of rFDA” comments junior researcher and team member, Wilson Simone.

The ADAM project began in November 2020 and is expected to end in 2024. It was subdivided into three consecutive phases, more specifically, the design phase of the strategy (implementation guides, surveys, consultations with partners, etc.), the implementation phase (the current one) and the phase of incorporating the results and recommendations of the study into the NMCP policies, guidelines and/or strategies.

The ultimate goal is to develop a policy to implement MDA and rFDA in “programmatic mode

The project is coordinated by CISM, in a consortium that involves the NMCP and the Barcelona Institute for Global Health (ISGlobal). The ultimate objective is to develop a policy to implement MDA and rFDA in “programmatic mode”, that is, through the national health system. One of the main objectives of the project is to improve the delivery strategy, including the creation of a data collection and visualization system to facilitate monitoring of activities, in collaboration with stakeholders. The feasibility and operational performance of the strategy are being assessed through a pilot implementation, and lessons learned will be used to inform the development of policies and guidelines for future implementations of MDA and rFDA led by the PNCM.