Hsiang MS, Ntuku H, Roberts KW, et al. - Researchers investigated the effectiveness of reactive focal mass drug administration (rfMDA) and reactive focal vector control (RAVC) in the low malaria-endemic setting of Zambezi (Namibia) via performing a cluster-randomized controlled, open-label trial using a two-by-two factorial design of 56 enumeration area clusters in this setting. The clusters were randomized to four groups: RACD only, rfMDA only, RAVC plus RACD, or rfMDA plus RAVC. In RACD, rapid diagnostic testing and treatment with artemether-lumefantrine and single-dose primaquine were involved; in rfMDA, presumptive treatment with artemether-lumefantrine was involved, and in RAVC, indoor residual spraying with pirimiphos-methyl was involved. Interventions were administered within 500 m of index cases. Per outcomes, there was reduction in malaria transmission in a low malaria-endemic setting with implementation of rfMDA and RAVC, alone and in combination, and hence these should be considered as alternatives to RACD for elimination of malaria.