Abstract
BackgroundWith a decline in malaria burden, innovative interventions and tools are required to reduce malaria transmission further. Mass drug administration (MDA) of artemisinin-based combination therapy (ACT) has been identified as a potential tool to further reduce malaria transmission, where coverage of vector control interventions is already high. However, the impact is limited in time. Combining an ACT with an endectocide treatment that is able to reduce vector survival, such as ivermectin (IVM), could increase the impact of MDA and offer a new tool to reduce malaria transmission.ObjectiveThe study objective is to evaluate the impact of MDA with IVM plus dihydroartemisinin-piperaquine (DP) on malaria transmission in an area with high coverage of malaria control interventions.MethodsThe study is a cluster randomized trial in the Upper River Region of The Gambia and included 32 villages (16 control and 16 intervention). A buffer zone of ~2 km was created around all intervention clusters. MDA with IVM plus DP was implemented in all intervention villages and the buffer zones; control villages received standard malaria interventions according to the Gambian National Malaria Control Program plans.ResultsThe MDA campaigns were carried out from August to October 2018 for the first year and from July to September 2019 for the second year. Statistical analysis will commence once the database is completed, cleaned, and locked.ConclusionsThis is the first cluster randomized clinical trial of MDA with IVM plus DP. The results will provide evidence on the impact of MDA with IVM plus DP on malaria transmission.Trial RegistrationClinicalTrials.gov NCT03576313; https://clinicaltrials.gov/ct2/show/NCT03576313International Registered Report Identifier (IRRID)DERR1-10.2196/20904
Highlights
Mass drug administration (MDA) with IVM plus DP was implemented in all intervention villages and the buffer zones; control villages received standard malaria interventions according to the Gambian National Malaria Control Program plans
Between 2000 and 2015, the burden of malaria decreased substantially in sub-Saharan Africa following the scale-up of insecticide-treated bed nets (ITNs), indoor residual spraying (IRS), and artemisinin-based combination therapy [1,2]
Dihydroartemisinin-piperaquine (DP), thanks to its simple dosing schedule, long posttreatment prophylaxis period, good safety profile [10,11], and the fact that it is not used as a first-line antimalarial treatment in The Gambia, is a promising candidate for MDA
Summary
Between 2000 and 2015, the burden of malaria decreased substantially in sub-Saharan Africa following the scale-up of insecticide-treated bed nets (ITNs), indoor residual spraying (IRS), and artemisinin-based combination therapy [1,2]. Mass drug administration (MDA), a full antimalarial treatment to all inhabitants of target communities regardless of their infection status, has been identified as a potential tool to further reduce transmission where coverage of vector control interventions is already high [8,9]. The effect of MDA with ACT on malaria is limited over time [12,13] This limited impact is largely attributed to incomplete coverage and the persistence of malaria parasites in the mosquito population, with a smaller contribution to residual transmission of gametocytes remaining after ACT administration [14]. Mass drug administration (MDA) of artemisinin-based combination therapy (ACT) has been identified as a potential tool to further reduce malaria transmission, where coverage of vector control interventions is already high. Combining an ACT with an endectocide treatment that is able to reduce vector survival, such as ivermectin (IVM), could increase the impact of MDA and offer a new tool to reduce malaria transmission
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
