Mass treatment (mass drug administration) of all or a large section of the population whether symptoms are present or not) has been carried out in the past, usually in conjunction with insecticide residual spraying, as a way of controlling epidemics. Analysis of 19 mass drug administration projects during the period 1932-1999 did not draw definitive conclusions because study designs were so variable.20 Many projects were unsuccessful, although a reduction in parasite prevalence and some transient reduction in mortality and morbidity occurred in some cases. Reduced transmission was seen only in one study, in Vanuatu, where the population concerned was relatively small, well defined and controlled.
20 von Seidlein L, Greenwood BM. Mass administration of antimalarial drugs. Trends in Parasitology, 2003, 19:790-796.
There is no convincing evidence for the benefits of mass treatment. Mass treatment of symptomatic febrile patients is considered appropriate in epidemic and complex emergency situations. Whenever this strategy is adopted, a full treatment course should be given.