Effects of ivermectin mass drug administration for malaria vector control on ectoparasites and soil-transmitted helminths: a cluster randomized trial

Int J Infect Dis. 2022 Dec:125:258-264. doi: 10.1016/j.ijid.2022.10.043. Epub 2022 Nov 3.

Abstract

Objectives: Ivermectin, used to control several neglected tropical diseases, may also reduce malaria transmission. Mass drug administration (MDA) for malaria control therefore might have off-target impacts on neglected tropical diseases.

Methods: In The Gambia, nested in a trial of ivermectin MDA, cross-sectional surveys measuring ectoparasites and soil-transmitted helminths in children aged 3 to 14 years took place in June and November 2019 and in November 2021.

Results: After MDA, scabies prevalence was 41.2% (237/576) in the control and 38.2% (182/476) in the intervention arm (odds ratio [OR] 0.89 (95% confidence interval [CI] 0 67-1.2), P-value = 0.471) but by 2021, had rebounded to 38.8% (180/464) in the control and 53.2% (245/458) in the intervention arm. After MDA, prevalence of Strongyloides stercoralis was 16.8% (87/518) in the control and 9.1% (40/440) in the intervention arm (OR 0.4 (95% CI 0.16-0.94), P-value = 0.039). In 2021, it was 9.2% (38/413) in the control and 11.3% (45/399) in the intervention arm (OR 1.31 (95% CI 0.74-2.28), P-value = 0.35).

Conclusion: Scabies prevalence was similar between the two study arms. S. stercoralis prevalence was reduced. However, this effect did not last long: the prevalence 2 years after MDA was similar between study arms.

Keywords: Ivermectin; MDA; Malaria; STH; Scabies.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Animals
  • Anopheles*
  • Child
  • Cross-Sectional Studies
  • Helminths*
  • Humans
  • Ivermectin / therapeutic use
  • Malaria* / drug therapy
  • Malaria* / epidemiology
  • Malaria* / prevention & control
  • Mass Drug Administration
  • Mosquito Vectors
  • Neglected Diseases / epidemiology
  • Prevalence
  • Scabies* / drug therapy
  • Scabies* / epidemiology
  • Scabies* / prevention & control
  • Soil

Substances

  • Ivermectin
  • Soil