{"doi":"10.1093/ofid/ofaf465","title":"Efficacy of Focal Primaquine Mass Administration for Eliminating <i>Plasmodium vivax</i> Malaria in Northern Myanmar: A Cluster-Randomized Trial","abstract":"Abstract Background Plasmodium vivax poses a major challenge for malaria elimination, primarily because of relapse. Primaquine mass drug administration (PQ-MDA) has played a decisive role in eliminating vivax malaria in many temperate countries, but its efficacy in tropical/subtropical areas remains underexplored. Methods We conducted a cluster-randomized crossover trial to determine the effect of PQ-MDA on P. vivax transmission in northern Myanmar, a subtropical area in the Greater Mekong subregion with perennial malaria transmission. Participants from two groups of villages (groups 1 and 2) were administered 0.25 mg/kg/day PQ base for 14 days as directly observed therapy. During PQ-MDA administration, each group alternated as the control while the other received the intervention, with the groups switching after 9 months. Clinical malaria incidence and prevalence were monitored to determine the efficacy. Results PQ was administered in 541 participants in group 1 and 667 in group 2 during August–September 2019 and June–July 2020, respectively. In both groups, clinical P. vivax incidence sharply declined to zero within a month of PQ-MDA and remained vivax-free for almost a year. During round 1 PQ-MDA, group 1 with MDA had a significant reduction in the prevalence of subclinical P. vivax compared to group 2 as the control, with a model-adjusted odds ratio (aOR) of 0.46 [95% confidence interval (CI): 0.25–0.83]. During round 2, group 2 exhibited an even lower aOR of 0.15 (95% CI: 0.03–0.65) for subclinical P. vivax infection. Conclusions PQ-MDA was effective in reducing both clinical and subclinical P. vivax infections in a subtropical, low-endemicity setting. ClinicalTrialsRegistration This study was registered with ClinicalTrials.gov (NCT06392152).","journal":"Open Forum Infectious Diseases","year":2025,"id":528597,"datarank":0.16479184330021646,"base_score":1.0986122886681096,"endowment":1.0986122886681096,"self_citation_contribution":0.16479184330021646,"citation_network_contribution":0.0,"self_endowment_contribution":0.16479184330021646,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":2,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9499,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT06392152"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":310069,"name":"Myat Thu Soe","orcid":null,"position":1,"is_corresponding":false},{"id":764139,"name":"Than Naing Soe","orcid":"0000-0001-9208-929X","position":2,"is_corresponding":false},{"id":308906,"name":"Yan Zhao","orcid":"0000-0002-7760-916X","position":3,"is_corresponding":false},{"id":390281,"name":"Yaming Cao","orcid":"0000-0002-1547-3033","position":4,"is_corresponding":false},{"id":764140,"name":"Poe Poe Aung","orcid":"0000-0001-9404-4423","position":5,"is_corresponding":false},{"id":735550,"name":"Thit Lwin Oo","orcid":null,"position":6,"is_corresponding":false},{"id":378078,"name":"Saranath Lawpoolsri","orcid":"0000-0003-4841-7924","position":7,"is_corresponding":false},{"id":406895,"name":"Wang Nguitragool","orcid":"0000-0002-5484-7130","position":8,"is_corresponding":false},{"id":334155,"name":"Jetsumon Sattabongkot","orcid":"0000-0002-3938-4588","position":9,"is_corresponding":false},{"id":337849,"name":"Jaranit Kaewkungwal","orcid":"0000-0001-7916-8460","position":10,"is_corresponding":false},{"id":310071,"name":"Myat Phone Kyaw","orcid":null,"position":11,"is_corresponding":false},{"id":642318,"name":"Daniel M. Parker","orcid":"0000-0002-5352-7338","position":12,"is_corresponding":false},{"id":308914,"name":"Liwang Cui","orcid":"0000-0002-8338-1974","position":13,"is_corresponding":false},{"id":308908,"name":"Pyae Linn Aung","orcid":"0000-0003-4635-3701","position":0,"is_corresponding":true}],"reference_count":46,"raw_metadata":null,"created_at":"2026-07-19T02:50:48.492873Z","pmid":"40799786","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}