Ivermectin as a novel complementary malaria control tool to reduce incidence and prevalence: a modelling study

Slater, Hannah C., Foy, Brian D, Kobylinski, Kevin, Chaccour, Carlos, Watson, Oliver J., Hellewell, Joel, Aljayyoussi, Ghaith, Bousema, Teun, Burrows, Jeremy, D’Alessandro, Umberto, Alout, Haoues, terKuile, Feiko ORCID: https://orcid.org/0000-0003-3663-5617, Walker, Patrick G.T., Ghani, Azra C. and Smit, Menno ORCID: https://orcid.org/0000-0003-3405-6638 (2020) 'Ivermectin as a novel complementary malaria control tool to reduce incidence and prevalence: a modelling study'. Lancet Infectious Diseases, Vol 20, Issue 4, P498-508.

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Abstract

Background: Ivermectin has been identified as a potential new vector control tool to reduce malaria transmission. Mosquitoes feeding on a bloodmeal containing ivermectin have been shown to have a reduced lifespan, meaning they are less likely to live long enough to complete sporogony and become infectious.

Methods: In this study, we validate an existing population-level mathematical model of the impact of ivermectin on the mosquito population and malaria transmission to entomological and clinical data.
The model is extended to include a range of complementary malaria interventions and to incorporate new data on higher doses with a longer mosquitocidal effect. We then simulate the impact of these
doses in a range of usage scenarios in different transmission settings.

Findings: Mass drug administration (MDA) with ivermectin is predicted to reduce prevalence and incidence and is most effective in areas with a relatively short transmission season. In a highly seasonal moderate transmission setting, three rounds of ivermectin-only MDA spaced one month apart with a dose of 3x300μg/kg and 70% coverage is predicted to reduce clinical incidence by 71% and prevalence by 34% We predict that adding ivermectin MDA to seasonal malaria chemoprevention in this setting will reduce clinical incidence by an additional 77% in under 5-year olds. Adding ivermectin MDA to MDA with antimalarials in this setting is predicted to reduce incidence by an additional 75%.

Interpretation: Ivermectin is a novel vector control tool that targets residual transmission, it has an excellent safety profile and has operationally synergistic distribution schedules with existing malaria
interventions. Based on modelling predictions in this study, we propose that this drug could be a valuable addition to the malaria control toolbox, both in areas with persistently high transmission where existing vector control is insufficient and in areas approaching elimination to prevent resurgence.

Item Type:	Article
Subjects:	QV Pharmacology > Anti-Inflammatory Agents. Anti-Infective Agents. Antineoplastic Agents > QV 250 Anti-infective agents (General) WC Communicable Diseases > Tropical and Parasitic Diseases > WC 680 Tropical diseases (General) WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/S1473-3099(19)30633-4
Depositing User:	Helen Wong
Date Deposited:	14 Jan 2020 14:50
Last Modified:	13 Jul 2020 01:02
URI:	https://archive.lstmed.ac.uk/id/eprint/13302

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