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

Area of Science:

• Vector-borne disease control
• Mathematical modeling in epidemiology
• Pharmacological interventions for infectious diseases

Background:

• Ivermectin exhibits mosquitocidal properties, reducing mosquito lifespan and thus malaria transmission potential.
• Existing mathematical models can be adapted to assess ivermectin's impact on malaria transmission.

Purpose of the Study:

• To estimate the effect of ivermectin mass drug administration (MDA) on malaria transmission across various usage scenarios.
• To evaluate ivermectin's efficacy when used alone or in conjunction with other malaria control interventions.

Main Methods:

• Validated a population-level mathematical model using clinical and entomological data from West Africa.
• Extended the model to incorporate complementary interventions and higher ivermectin doses.
• Simulated two ivermectin regimens (single 400 µg/kg or 3x 300 µg/kg daily) in diverse transmission settings.

Main Results:

• Ivermectin MDA is predicted to be most effective in highly seasonal transmission settings.
• Three rounds of ivermectin MDA (3x 300 µg/kg) with 70% coverage could reduce clinical incidence by 71% and prevalence by 34%.
• Adding ivermectin MDA to seasonal malaria chemoprevention or dihydroartemisinin-piperaquine MDA significantly boosted reductions in incidence and prevalence.

Conclusions:

• Ivermectin MDA is a promising tool for malaria control, particularly in areas with high or seasonal transmission.
• Ivermectin can enhance existing malaria control strategies, aiding in reducing transmission and preventing resurgence in elimination settings.