Last Updated

18 Dec 2018

MESA grantee shares findings

Another MESA grantee has finalised its projects and shared the findings. Here is a short summary of progress.

 

The MESA-funded IVERMAL Study, a randomised, double-blind, placebo-controlled trial conducted in Kenya and led by the Liverpool School of Tropical Medicine (LSTM) has produced new evidence that supports the use of ivermectin as a tool for malaria elimination. 

This clinical trial published in Lancet Infectious Diseases aimed to establish the safety, tolerability, and mosquitocidal efficacy of 3-day courses of high-dose ivermectin, coadministered with dihydroartemisinin-piperaquine, a standard malaria treatment. 

Between July 2015 and May 2016, 141 adults with uncomplicated malaria were randomly assigned to receive ivermectin at the doses of 600 μg/kg per day or 300 μg/kg per day, or placebo; during 3 days and co-administered with dihydroartemisinin-piperaquine. Blood of patients was taken post-treatment and was used to feed laboratory-reared Anopheles gambiae sensu stricto mosquitoes. Mosquito survival was then assessed daily during 28 days after feeding.  

According to the study, adding 3 days of ivermectin to the standard 3-day antimalarial treatment was well tolerated and associated with a large effect on mortality among the mosquitoes that had fed on blood taken from ivermectin-treated patients. The mosquitocidal effects lasted up to 28 days, longer than the effects seen in previous studies. 

According to the researchers "the combination of an artemisinin-based combination therapy and ivermectin targets both the malaria parasite and its vector, a unique property among malaria interventions that has the potential to reduce onward transmission of antimalarial drug-resistant parasites. The long effect duration, tolerability, and unique mosquito killing action of these regimens make ivermectin a promising new option for malaria elimination".  

In a linked article, Regina Rabinovich, chair of MESA, highlights the importance of this study in the path to consider ivermectin a "credible" complementary malaria vector control intervention. She also underlines that "given the high variability of the vector and the parasite, more than one approach will probably be needed to confront this challenge. If ivermectin is effective, new endectocides that could safely provide similar benefits with improved characteristics like longer duration of action, could be developed".