Ali AS, et al. – Authors undertook this work to report on programmatic coverage and compliance of Mass drug administration (MDA) using artemisinin–based combination therapy (ACT) in four shehias (smallest administration unit) that had been identified as hotspots through Zanzibar’s malaria case notification surveillance system. Observations revealed that the communities at high risk of malaria well accepted the mass drug administration for malaria, with high participation and completion rates. They suggest further work to investigate the potential of MDA in accelerating Zanzibar’s efforts towards malaria elimination.