A recent study published in The New England Journal of Medicine has revealed that mass administration of ivermectin, a drug long used for treating river blindness and scabies, can significantly reduce malaria transmission when combined with insecticide-treated bed nets. The findings come from the BOHEMIA trial, the largest study of its kind, which demonstrated a 26% reduction in new malaria infections on top of existing prevention methods.What Does The Study Say: The BOHEMIA TrialThe BOHEMIA project (Broad One Health Endectocide-based Malaria Intervention in Africa) was coordinated by the Barcelona Institute for Global Health (ISGlobal), with support from the “la Caixa” Foundation, and conducted in collaboration with the Manhica Health Research Centre (CISM) in Mozambique and the KEMRI-Wellcome Trust Research Programme in Kenya.The trial involved two large-scale Mass Drug Administration (MDA) programs in Kwale County, Kenya, and Mopeia district, Mozambique. Participants received a monthly dose of ivermectin (400 mcg/kg) for three consecutive months during the rainy season. In total, more than 20,000 participants took part, and over 56,000 treatments were administered.Why Is A New Approach Needed?Malaria remains a major global health threat. In 2023 alone, there were 263 million cases worldwide, leading to nearly 600,000 deaths. Standard prevention measures such as long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) have been losing effectiveness due to growing insecticide resistance and changes in mosquito behavior. Mosquitoes increasingly bite outdoors or during hours when people are not under bed nets, limiting the reach of existing strategies.Also Read: Fact Check: Can Ivermectin Really Treat Cancer?This urgent challenge has fueled research into innovative tools like ivermectin. While the drug has historically been used against neglected tropical diseases such as onchocerciasis (river blindness) and lymphatic filariasis (elephantiasis), researchers have discovered that mosquitoes feeding on individuals treated with ivermectin die, thereby reducing malaria transmission.Results From Kenya and MozambiqueIn Kwale County, Kenya, where the intervention targeted children aged 5 to 15, ivermectin led to a 26% reduction in malaria incidence compared to the control group treated with albendazole. In Mozambique, where the study focused on children under five, the drug also showed promise in curbing transmission.Importantly, the safety profile of ivermectin was reassuring. No severe adverse drug reactions were recorded, and only mild, short-lived side effects were reported, consistent with previous campaigns where the drug was used against other parasitic diseases.Expert Reactions and Global SignificanceResearchers leading the trial have expressed optimism. “Ivermectin has shown great promise in reducing malaria transmission and could complement existing control measures. With continued research, it could become an effective tool for malaria elimination,” said Carlos Chaccour, co-principal investigator of the BOHEMIA project.The findings also meet the World Health Organisation’s (WHO) criteria for evaluating new vector control tools. According to Joseph Mwangangi of the KEMRI-Wellcome Trust Research Programme, ivermectin could be a vital complementary strategy in areas grappling with insecticide resistance. BOHEMIA’s lead entomologist, Marta Maia of the University of Oxford, echoed this view, noting that the results highlight ivermectin’s potential to bolster malaria control programs.What Comes Next?The WHO vector control advisory group has reviewed the findings and confirmed their impact, recommending further large-scale studies. Results have also been shared with national health authorities, who will consider whether ivermectin should be included in official malaria control programs.While more evidence is needed, the BOHEMIA trial marks a significant step forward in the global fight against malaria. If scaled effectively, ivermectin could become a powerful complement to existing tools, offering new hope in reducing the burden of one of the world’s deadliest diseases.
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