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Similar to the plots for EIR, IRS and ITNs reduce prevalence in their first two deployments but do not lead to further reductions, and return to preintervention levels after the interventions are stopped.
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These interventions are stopping smoking, promoting single pregnancies in IVF treatments, reducing planned Caesarean sections - which are often carried out before due dates - unless there is a medical reason by 80%, providing progesterone supplements to women with high-risk pregnancies and cervical stitches for women with a "weak" cervix that could mean a baby does not go to term.
On follow-up after the studies ended and the interventions were stopped or reduced, additional study participants developed diabetes.
When the deployment of interventions is stopped, transmission and prevalence quickly revert to preintervention levels, so high coverage levels of interventions must be sustained to maintain reductions in transmission and prevalence.
Considering the drastic disease progression under maximal multimodal care further therapeutic interventions were stopped in consent with the patient and his family and palliative home care support was initiated.
In the end, the police intervention was stopped because the mock victims were not dressed for the cold weather and began to show signs of exposure.
Some rebound in malaria morbidity was reported following sustained chemoprophylaxis [7], [8] and some IPT studies have reported increased incidence of clinical malaria or anaemia in sub-groups of subjects when the intervention was stopped [9], [10], [11].
At the first survey after the intervention was stopped, the prevalence of P. falciparum infection by microscopy was lower (5.2%) in children who had received monthly AS+AQ treatment compared to children given placebo (19.8%) (p<0.05, Chi-square, Table 1).
In this Gambian study there was an increase in the incidence of clinical attacks of malaria in the year after the intervention was stopped which was most marked in children who had received chemoprophylaxis during each of the first five years of life.
The intervention was stopped at 6 months and the results were published (3).
Furthermore, compliance can decrease dramatically when an intervention is stopped and then restarted.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com