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Efficacy and Safety of High-Dose Ivermectin for Reducing Malaria Transmission (IVERMAL): Protocol for a Double-Blind, Randomized, Placebo-Controlled, Dose-Finding Trial in Western Kenya

2016; JMIR Publications; Volume: 5; Issue: 4 Linguagem: Inglês

10.2196/resprot.6617

1929-0748

Menno R. Smit, Eric Ochomo, Ghaith Aljayyoussi, Titus K. Kwambai, Bernard Abong’o, Nabie Bayoh, John E. Gimnig, Aaron M. Samuels, Meghna Desai, Penelope A. Phillips–Howard, Simon Kariuki, Duolao Wang, Stephen A. Ward, Feiko O. ter Kuile,

Parasites and Host Interactions

Innovative approaches are needed to complement existing tools for malaria elimination. Ivermectin is a broad spectrum antiparasitic endectocide clinically used for onchocerciasis and lymphatic filariasis control at single doses of 150 to 200 mcg/kg. It also shortens the lifespan of mosquitoes that feed on individuals recently treated with ivermectin. However, the effect after a 150 to 200 mcg/kg oral dose is short-lived (6 to 11 days). Modeling suggests higher doses, which prolong the mosquitocidal effects, are needed to make a significant contribution to malaria elimination. Ivermectin has a wide therapeutic index and previous studies have shown doses up to 2000 mcg/kg (ie, 10 times the US Food and Drug Administration approved dose) are well tolerated and safe; the highest dose used for onchocerciasis is a single dose of 800 mcg/kg.