A groundbreaking study has revealed that the mass administration of ivermectin a drug once known for treating river blindness and scabies can significantly reduce malaria transmission when used in conjunction with bed nets.
Ivermectin, when administered to entire populations, showed a 26% reduction in new malaria infections beyond the protection already provided by bed nets. This finding offers new hope in the fight against malaria.
The BOHEMIA trial (Broad One Health Endectocide-based Malaria Intervention in Africa) the largest study on ivermectin for malaria to date was coordinated by the Barcelona Institute for Global Health (ISGlobal) with support from the “la Caixa” Foundation, in collaboration with Manhiça Health Research Centre (CISM) and the KEMRI-Wellcome Trust Research Programme. The results were published in The New England Journal of Medicine.
Malaria continues to be a major global health challenge, with 263 million cases and 597,000 deaths reported in 2023. Existing vector control methods like long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are losing effectiveness due to insecticide resistance and changes in mosquito behavior, with more bites occurring outdoors or during dusk and dawn.
This highlights the urgent need for innovative tools to tackle the disease.
Ivermectin, traditionally used to treat neglected tropical diseases such as onchocerciasis (river blindness) and lymphatic filariasis (elephantiasis), reduces malaria transmission by killing mosquitoes that feed on treated individuals. With growing resistance to traditional insecticides, ivermectin could become a vital weapon in malaria control.
The Unitaid-funded BOHEMIA project conducted mass drug administration (MDA) trials in Kwale County (Kenya) and Mopeia District (Mozambique). The trials tested a single monthly dose of ivermectin (400 mcg/kg) over three consecutive months during the rainy season.
In Kenya, the trial focused on children aged 5–15, while in Mozambique it targeted children under five. In Kwale County, children receiving ivermectin saw a 26% reduction in malaria incidence compared to those who received albendazole, the control drug.
Over 20,000 participants and 56,000 treatments were involved. The study showed the most impact in children living farther from cluster borders or in areas where distribution was efficient.
Importantly, the safety profile of ivermectin was favorable, with no severe drug-related events and only mild, temporary side effects consistent with its past use against tropical diseases.
“We are thrilled with these results,” said Carlos Chaccour, co-principal investigator of the BOHEMIA project.
“With continued research, ivermectin MDA could become an effective tool for malaria control and even contribute to elimination efforts.”
“These results align with WHO’s criteria for new vector control tools,” added Joseph Mwangangi of the KEMRI-Wellcome Trust.
“Ivermectin MDA could be a valuable complementary strategy,” said Marta Maia, lead entomologist from the University of Oxford.
The findings have been reviewed by the WHO vector control advisory group and shared with national health authorities to evaluate inclusion of ivermectin in national malaria control programs.
(With inputs from ANI)
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