RT Journal Article SR Electronic T1 Herd protection against Plasmodium falciparum infections conferred by mass antimalarial drug administrations and the implications for malaria elimination JF bioRxiv FD Cold Spring Harbor Laboratory SP 393843 DO 10.1101/393843 A1 Daniel M. Parker A1 Sai Thein Than Tun A1 Lisa J. White A1 Ladda Kajeechiwa A1 May Myo Thwin A1 Jordi Landier A1 Victor Chaumeau A1 Vincent Corbel A1 Arjen M. Dondorp A1 Lorenz von Seidlein A1 Nicholas J. White A1 Richard J. Maude A1 François H. Nosten YR 2018 UL http://biorxiv.org/content/early/2018/09/05/393843.abstract AB The global malaria burden has decreased over the last decade and many nations are attempting elimination. Asymptomatic infections aren’t normally diagnosed or treated, posing a major hurdle for elimination efforts. One solution to this problem is mass drug administration (MDA), which is dependent on adequate population participation to disrupt transmission. There is little empirical evidence regarding the necessary threshold level of participation. Here we present a detailed spatiotemporal analysis of malaria episodes and asymptomatic infections in four villages undergoing MDA in Myanmar. Individuals from neighborhoods with high MDA adherence had 90% decreased odds of having a malaria episode post-MDA, regardless of individual participation, suggesting a strong herd effect. High mosquito biting rates, living in a house with someone else with malaria, or having an asymptomatic malaria infection were also predictors of clinical episodes. Spatial clustering of non-adherence to MDA, even in villages with high overall participation, can frustrate elimination efforts.