Thirty years ago then veterinary drug, ivermectin, was found effective in controlling neglected tropical diseases (NTDs), specifically human filarial diseases onchocerciasis and lymphatic filariasis (LF). Since then annual community based mass drug administration (MDA) efforts have resulted in millions of treatments in endemic countries. Through observation and experimentation, ivermectin was found to kill malaria carrying mosquitoes when they bite people who have taken ivermectin. Current research is examining how dosing and timing of treatments may impact national malaria vector control efforts. Comparing maps between malaria and LF can be a starting point for adapting ivermectin MDAs for malaria vector control.
Burkina Faso MDAs are operationalized by community health workers (CHWs) who are part of a national program that provides treatment for common illnesses and also conducts village level LF MDAs. Mapping shows 10 of 70 health districts are currently doing LF MDA, though all have done it. Thus CHWs in all districts are experienced in ivermectin MDA. The malaria map shows that two-thirds of districts have a malaria incidence of 400/1000 or more while 14 have lower incidence. There is an overlap between current LF MDA districts and higher incidence malaria districts.
Ghana provides a contrasting example. There five regions in central Ghana that are mostly non-endemic for LF but do have moderate malaria transmission. In the south two regions with former LF MDA activity overlap with higher malaria endemicity. While four northern regions have lower malaria parasite prevalence, they do have current and recent LF MDAs.
Malaria elimination will still need a mix of strategies to be successful. Therefore, it is not too early for malaria and NTD program managers as well as their respective donors to begin comparing maps to identify possibilities for adapting ivermectin MDAs for malaria vector control.