  Plasmodium vivax is the most geographically widespread malaria parasite due
to its ability to remain dormant (as a hypnozoite) in the human liver and
subsequently reactivate. Given the majority of P. vivax infections are due to
hypnozoite reactivation, targeting the hypnozoite reservoir with a radical cure
is crucial for achieving P. vivax elimination. Stochastic effects can strongly
influence dynamics when disease prevalence is low or when the population size
is small. Hence, it is important to account for this when modelling malaria
elimination.cWe use a stochastic multiscale model of P. vivax transmission to
study the impacts of multiple rounds of mass drug administration (MDA) with a
radical cure, accounting for superinfection and hypnozoite dynamics. Our
results indicate multiple rounds of MDA with a high-efficacy drug are needed to
achieve a substantial probability of elimination. This work has the potential
to help guide P. vivax elimination strategies by quantifying elimination
probabilities for an MDA approach.
