Figure 3.

Mean Plasmodium falciparum and Plasmodium vivax incidence in hotspots before and after mass drug administration

Data are (A) centred on the date of mass drug administration. Each hotspot contributes different lengths of follow-up before and after mass drug administration. The median follow-up before mass drug administration was 15 months (IQR 8–22), including addressed hotspots (median 12 months, 5–16, n=50) and hotspots remaining unaddressed (median 32 months, 25–33, n=18). The median follow-up after mass drug administration was 20 months (IQR 14–24, n=50). A marked decrease in P falciparum incidence after mass drug administration is observable, despite an increase in incidence around 15 months after mass drug administration. This increase is related to five hotspots (of 52 followed up to month 18) showing an incidence above 50 cases per 1000 individuals for 1 month during the second year after mass drug administration. This increase did not persist. Other graphs show incidence by duration since malaria post opening, according to before, or after, mass drug administration status for (B) P falciparum and (C) P vivax. Non-hotspot incidence trend (dashed line) is presented for reference. Different numbers of villages contributed to each estimate according to the timing of their mass drug administration.