Ivermectin Boosts Malaria Defense Alongside Bed Nets
New Study Shows Drug’s Potential in Fighting Persistent Disease
A significant breakthrough in malaria control may be on the horizon, as a large-scale trial indicates that widespread distribution of ivermectin, coupled with existing bed net strategies, can substantially curb disease transmission.
Promising Results from BOHEMIA Trial
The BOHEMIA trial, the most extensive study to date on ivermectin’s role in malaria prevention, revealed a 26% reduction in new infections when the drug was administered to entire populations. This adds a vital new layer of defense to established methods like insecticide-treated bed nets.
The collaborative effort, led by the Barcelona Institute for Global Health (ISGlobal) and involving the Manhica Health Research Centre (CISM) and the KEMRI-Wellcome Trust Research Programme, published its findings in The New England Journal of Medicine.
Addressing Growing Resistance and Efficacy Gaps
Malaria continues to pose a critical global health threat, with millions of cases and hundreds of thousands of deaths annually. Current tools like long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are facing challenges due to increasing insecticide resistance and mosquitoes adapting to bite outside protected hours.
This escalating resistance highlights the urgent need for innovative interventions. Ivermectin, historically used for treating parasitic diseases like river blindness and elephantiasis, works by killing mosquitoes that feed on individuals who have taken the drug.
This mechanism offers a new avenue to combat malaria transmission, particularly in regions where traditional insecticides are losing their effectiveness.
Mass Drug Administration Trial Details
The Unitaid-funded BOHEMIA project conducted two Mass Drug Administration (MDA) trials in high-malaria regions of Kenya and Mozambique. The study evaluated the safety and efficacy of a monthly ivermectin dose (400 mcg/kg) over three consecutive months at the onset of the rainy season.
In Kenya’s Kwale County, the intervention targeted children aged 5-15. In Mozambique’s Mopeia district, the focus was on children under five. Over 20,000 participants received more than 56,000 treatments in total.
The Kenyan arm of the trial demonstrated that children receiving ivermectin experienced a 26% lower incidence of malaria compared to a control group that received albendazole. The reduction was more pronounced in children residing further from cluster borders or in areas with more efficient drug distribution.
The safety profile of ivermectin was found to be favorable, with no severe adverse events linked to the drug and only minor, temporary side effects consistent with previous ivermectin campaigns.
Expert Optimism for Malaria Control
“We are thrilled with these results. Ivermectin has shown great promise in reducing malaria transmission and could complement existing control measures. With continued research, ivermectin MDA could become an effective tool for malaria control and even contribute to elimination efforts.”
—Carlos Chaccour, Former ISGlobal Researcher and BOHEMIA Co-Principal Investigator
Joseph Mwangangi of the KEMRI-Wellcome Trust Research Programme noted that these findings align with the World Health Organization’s (WHO) criteria for new vector control tools. Similarly, Marta Maia, BOHEMIA’s lead entomologist from the University of Oxford, stated, “The findings suggest that ivermectin MDA could be a valuable complementary strategy for malaria control, particularly in areas where mosquito resistance to insecticides is a growing concern.”
The WHO’s vector control advisory group has reviewed the study, recognizing its impact and recommending further research. Findings are also being shared with national health authorities as they consider integrating ivermectin into their malaria control strategies. The WHO estimates that around 11 countries in Africa now have mosquitoes resistant to pyrethroids, the most common insecticide used in bed nets.
