The AMARETI project focuses on the asymptomatic reservoir of parasite carriers to strengthen the fight against malaria and reduce its transmission and burden in the Sahel.
Context
After a decade of decline, malaria incidence has plateaued in Senegal and other Sahel countries. In recent years, it has even increased despite ongoing interventions. Current strategies do not consider chronic, asymptomatic carriers of Plasmodium—the parasite responsible for malaria. Yet, these carriers sustain malaria during the dry season and form the reservoir from which transmission resumes each rainy season.
Description
AMARETI is grounded in the hypothesis that actively targeting asymptomatic carriers can help reduce malaria transmission and incidence. To this end, the project plans to conduct two mass antimalarial administration (MAA) campaigns at the start and end of the transmission season to drastically diminish the reservoir of carriers. During the transmission season, these campaigns will be supplemented by targeted activities focused on high-risk carrier groups. By combining these approaches in the same community, the goal is to sustainably lower the proportion of people infected with Plasmodium and thereby reduce transmission rates. The intervention will be assessed through a randomized trial in 50 villages in the Kédougou department (covering 18,000 people). The success of this study depends on broad community participation, which can only be ensured if the specific characteristics and constraints of each age and gender subgroup are considered during the design, awareness, and implementation phases.
Impact
If successful, this intervention will provide a new tool to reduce the duration and intensity of seasonal malaria transmission. The study will offer proof of concept that targeting the Plasmodium reservoir can affect transmission, thereby usefully complementing current control strategies focused on limiting severe forms of malaria in high-risk populations. More broadly, it will also document the conditions necessary for the success and sustainability of community-based public health interventions in rural Sahel settings.
