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A new trial shows that the invermectin killed by a mosquito reduces by a fifth the number of its cases
Mark Gould
Thursday, March 14, 2019
According to a new study *, the repeated repeated administration of a commonly used medication or pest control cream can reduce the incidence of malaria in children five years old or younger without increasing adverse effects for the general population.
Write in the Lancet According to scientists, invermectin trials conducted in Burkinabe villages have reduced malaria episodes in children by 20% – from 2.49 to two cases per child – during the transmission season. malaria if the whole population was treated every three weeks.
In addition, they say that repeated mbad administration of ivermectin has shown no apparent drug-related harm in villagers taking the drug.
Since 2000, the number of deaths from malaria has decreased by 48% worldwide and there are fewer endemic areas, but progress is declining due to increasing resistance to malaria. artemisinin. the drug that is integral to this success.
Ivermectin is used to treat parasitic infections such as river blindness and scabies up to lice. It is regularly distributed in the mbad administrations of drugs for the control of neglected tropical diseases. Previous studies have shown that it kills mosquitoes when they ingest human or animal blood treated with ivermectin, but no one has examined its effects on the clinical incidence of malaria.
Dr. Brian D Foy of Colorado State University (USA), author of the study, said, "Ivermectin reduces new cases of malaria by making the blood of a person deadly for mosquitoes that sting them, killing mosquitoes and thus reducing the risk of infection. Since ivermectin has a unique mode of action, compared to other antimalarial and antimalarial drugs, it could be used with drugs that treat malaria to fight against residual transmission of the disease . "
The study, funded by the Bill and Melinda Gates Foundation, aimed to test the safety and efficacy of a repeated mbadive administration of ivermectin to control malaria during a trial. of 18 weeks during the 2015 rainy season. Research focused on children, who have the heaviest burden of disease in hyperendemic communities because of their underdeveloped immunity. They invited eight villages to participate and four were badigned to each group. The intervention group included 1,447 participants, including 327 children, and the control group, 1,265, including 263 children.
All eligible residents – 1,080 in the intervention group and 999 in the control group – received a single dose of ivermectin from 150 to 200 μg / kg plus 400 mg of albendazole – a anti-worm medicine. The intervention group received another five doses of ivermectin every three weeks, reaching 70% to 75% of the administered mbad.
In the villages, children aged five years and under were screened for malaria every two weeks and treated if necessary. In the intervention group, 648 episodes of malaria occurred in 327 children and the control group saw 647 among 263 children. Episodes of malaria per child in the study villages were reduced by 20% in the intervention group compared to the control group – from 2.49 to two cases per child – with no obvious drug-related harm to population.
More than double the number of children in the intervention group had no episodes of malaria, compared to children in the control group: 20% [64/327 children] vs 9% [23/264 children].
Adverse events such as vomiting, pruritus, and limb edema were recorded in 3% (45 of 1,447) of the intervention group and 2% (24 of 1,265) of the control group. Similar rates of adverse events were seen in children (6% [18 of 327 children] in the intervention group and 5% [14 of 263 children] in the control group).
"Because of the ability of mosquitoes to adapt to control tools, new methods of preventing malaria transmission are needed, especially those targeting residual transmission. Ivermectin is well tolerated and widely used. It could therefore be a useful tool in reducing the disease if other trials show similar results, "Dr. Foy continues.
The authors note that the selected villages had been studied previously and routinely treated with ivermectin and albendazole in the years preceding this study. In addition, the size of their sample is relatively small and it was not possible to administer a placebo, which means that participants and study teams knew who was receiving a vaccine or not. treatment. The researchers attempted to mitigate this phenomenon by badigning each nurse to work in a village intervention group and in a village control group to control the effects on the nurse. The field doctor constantly monitored their work.
* BD Foy, Alut H, Seaman J., et al. Efficacy and risk of adverse effects related to the repeated administration of mbad drugs by ivermectin for the control of malaria (RIMDAMAL): randomized cluster trial. The Lancet, published March 13, 2019. DOI: 10.1016 / S0140-6736 (18) 32321-3
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