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No one has attempted it before: hunt down every malaria infection in a vast swathe of rural Africa in order to rid both people and mosquitoes of the most deadly malaria parasite, Plasmodium falciparum.

But after making huge strides in reducing malaria illnesses and deaths through prevention and control, Zambia is now a living laboratory for the pursuit of malaria-free zones and, ultimately, total elimination of the disease. We are working with Zambia's Ministry of Health on an aggressive approach pioneered by the Malaria Control and Evaluation Partnership in Africa (MACEPA), a program at PATH. The strategy is part of our work to help stop malaria transmission in countries in different stages of the fight against the disease, and develop a model for elimination across the continent.

The strategy consists of three steps. First, create a robust reporting system of malaria infections and locate hotspots. Next, send waves of health care teams out to track down and treat all infections. Finally, keep up the surveillance, investigate, and stamp out potential outbreaks before they start.

Dozens of “test and treat” teams are fanning out across Zambia. Carrying lab supplies and handheld computers across rivers and over miles of dirt paths, the teams are bringing hospital services to villages and, in the process, rapidly shrinking the malaria map.

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Eunice and George, a data collector and a health worker, are charged with tracking down every person infected with malaria in a village, including those without symptoms. The goal: eliminate malaria by halting the cycle of transmission from human to mosquito to human again. Photo: PATH/Laura Newman.

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Before the teams are dispatched, malaria hotspots are identified through “rapid reporting”—weekly reports of new malaria cases sent from the field via mobile phones. Teams may have to test and treat a village up to four times, bringing the number of infections down with each sweep. Photo: PATH/Laura Newman.

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Every member of a household gets blood drawn to test for malaria. The test and treat approach is unique in that it looks both for people who have symptoms and for those who don't but who are infected. Photo: PATH/Laura Newman.

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A health worker checks a test cassette for results. People with positive results are given the first dose of treatment on the spot. Photo: PATH/Laura Newman.

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When a single dark line appears across this test strip, 19-year-old Brassimo learns he isn't infected with malaria. But his seven-year-old brother Kaluba tests positive. Kaluba is given malaria pills and a bednet. Photo: PATH/Laura Newman.

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Local lakes and streams attract mosquitoes and sometimes challenge test and treat teams, who travel to the hardest-to-reach places to make sure all malaria infections are detected. After being stranded for three days by a flooded river, one duo finally waded through, carrying their supplies above their heads. Photo: PATH/Laura Newman.

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The test-and-treat approach has been so successful in reducing malaria that the staff of Chabbabboma Health Centre has more time to provide better care to patients with diarrhea, pneumonia, tuberculosis, and other severe illnesses. Photo: PATH/Laura Newman.

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When Esnart Nkoswe tested positive for malaria in an area with low malaria rates, it triggered an investigation. A team tested everyone in her household, including her husband Richard, as well as nearby homes and gave the family bednets. Photo: PATH/Laura Newman.