1612. Targeted Mass Drug Administration of antimalarials to control malaria in Lakonia Greece, 2013-2014
Session: Poster Abstract Session: Global Health
Saturday, October 10, 2015
Room: Poster Hall
  • IDSA2015postermalariaTsiodras.pdf (2.8 MB)
  • Background: Malaria re-emerged in Greece since 2009 after >35 yrs, with locally acquired P. vivaxcases. A malaria outbreak was detected in 2011 in Lakonia (36 local cases) with an additional 10 locally acquired cases in 2012. Public health measures were implemented including Proactive Case Detection (PACD) with fever screening, with Reactive ACD in the event of any malaria case, Indoor Residual Spraying (IRS), distribution of Long-lasting insecticide treated Nets (LLINs) and targeted mass antimalarial drug administration (tMDA) to migrants from malaria endemic countries living in the area.

    Methods: An empiric antimalarial course of chloroquine and primaquine was selected targeting P. vivaxhypnozoites after consultation with an intersectoral working group of experts. tMDA was implemented by field teams(1-2 health professionals and a mediator), providing the medicines for free daily under Directly Observed Therapy (DOT). Administration followed a mediator obtained informed consent and G6PD testing. Adverse effects were monitored daily in a structured pharmacovigilance form.



    Eligible to receive course

    Completed course (%)

    Refused (%)

    Lost to f/u (%)

    Side effects 

    (% reporting at least one)

    2013 (22/05- 31/12)


    862 (95%)

    3 (0,3%)

    41 (4,5%)

    Chloroquine 35.4%

    Primaquine 11.5% (1 haemolysis)

    2014 (28/06- 30/11/14)


    232 (89%)


    28 (10,7%)

    Chloroquine 27,5 %

    Primaquine 14,2%

    No haemolysis

    17 migrants in 2013 and 5 in 2014 had moderate or severe G6PD deficiency and were not offered the treatment.

    Conclusion: No cases of P. vivax malaria, locally acquired or imported, were detected in Evrotas either 2013 or in 2014. tMDA proved a safe public health measure, which in combination with the other interventions controlled the re-emergence of malaria in this focus in Greece.

    Maria Tseroni, RN, MSc1, Agoritsa Baka, MD2, Maria Georgitsou, MSc3, Maria Harvalakou, RN4, Maria Panoutsakou, MD4, Ioanna Psinaki, RN4, Panagiota Bleta, RN4, Maria Tsoromokou, Nurse Assistant4, George Karakitsos, Nurse Assistant4, Chrysovalantis Silvestros, RN, MSc5, Danai Pervanidou, MD6, Christina Kapizoni, MD4, Irene Terzaki, RN6, Anna Vakali, MSc7, Theano Georgakopoulou, MD, MPH, PhD5, Sotirios Tsiodras, MD, PhD, Assoc Professor8, Athanassios Tsakris, MD9, Jenny Kremastinou, MD, PhD10 and Christos Hadjichristodoulou, MD, MPH, PhD4, (1)Hellenic Center for Disease Control and Prevention, Marousi, Greece, (2)Hellenic Ctr for Disease Control & Prevention (HCDCP), Marousi, Greece, (3)Emerging and Vectorborne Diseases, University of Thessaly, Larissa, Greece, (4)Dept of Hygiene and Epidemiology, University of Thessaly, Larissa, Greece, (5)Epidemiology Surveillance and Response, Hellenic Centre for Disease Control and Prevention (HCDCP), Marousi, Greece, (6)Epidemiology and Intervention, Hellenic Centre for Disease Control and Prevention, Marousi, Greece, (7)Epidemiology Surveillance and Response, Hellenic Centre for Disease Control and Prevention (HCDCP), Athens, Greece, (8)4th Department of Internal Medicine, University of Athens Medical School, Athens, Greece, (9)Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece, (10)Public Health, National School of Public Health, Athens, Greece


    M. Tseroni, None

    A. Baka, None

    M. Georgitsou, None

    M. Harvalakou, None

    M. Panoutsakou, None

    I. Psinaki, None

    P. Bleta, None

    M. Tsoromokou, None

    G. Karakitsos, None

    C. Silvestros, None

    D. Pervanidou, None

    C. Kapizoni, None

    I. Terzaki, None

    A. Vakali, None

    T. Georgakopoulou, None

    S. Tsiodras, None

    A. Tsakris, None

    J. Kremastinou, None

    C. Hadjichristodoulou, None

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