Repeat Ivermectin Mass Drug Administrations for MALaria control II (RIMDAMAL II): a double-blind cluster randomized trial for integrated control of malaria

重复伊维菌素大规模药物管理用于疟疾控制 II (RIMDAMAL II)：疟疾综合控制的双盲整群随机试验

• 批准号: 9754784
• 负责人: BRIAN David FOY
• 金额: $ 70.43万
• 依托单位: COLORADO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9754784
• 关键词: 10 year old; Adopted; Africa; Age; Agriculture; Alleles; Amodiaquine; Anopheles Genus; Anti-malarial drug resistance; Antimalarials; Antiparasitic Agents; Artemisinins; Beds; Behavioral; Biological Assay; Bite; Blood; Burkina Faso; Cessation of life; Chemistry; Chemoprevention; Child; Childhood; Chloroquine; Clinical; Clinical Trials; Cluster randomized trial; Combined Modality Therapy; Communities; Country; Culicidae; Development; Dose; Double-Blind Method; Drops; Drug Combinations; Drug Kinetics; Drug resistance; Ensure; Entomology; Failure; Filarial Elephantiases; Future; Goals; Health; Human; Incidence; Individual; Infection; Ingestion; Insecticide Resistance; Insecticides; Intervention; Ivermectin; Link; Malaria; Measures; Monitor; Morbidity - disease rate; Mutation; Onchocerciasis; Organism; Parasite Control; Parasite resistance; Parasites; Pharmaceutical Preparations; Physiology; Plasmodium; Population; Predisposition; Pregnant Women; Prevalence; Prevention; Preventive treatment; Pyrimethamine-Sulfadoxine; Randomized Clinical Trials; Recipe; Recording of previous events; Residual state; Resistance; Resistance development; Safety; Seasons; Seminal; Southeastern Asia; Sporozoites; Sulfadoxine-pyrimethamine resistance; Testing; Time; aged; arm; artesunate; authority; base; combat; evidence base; experimental study; feeding; indexing; malaria transmission; mortality; neglected tropical diseases; neuromuscular; novel; optimism; preservation; primary endpoint; primary outcome; programs; pyrethroid; rapid diagnosis; resistance allele; success; survivorship; tool; vector; vector control

Project Summary / Abstract Enhanced malaria control efforts since the turn of the century have resulted in notable reductions in malaria morbidity and mortality. This success has been driven by the widespread distribution of long-lasting insecticide treated nets and targeted indoor residual spraying of insecticides to combat vectors as well as rapid diagnosing and treatment of malaria with artemesisin-based combination therapies, and chemoprevention programs for pregnant women and children. However, malaria control efforts are stagnating because programs targeting both the vector and the parasite are not well integrated, and the efficacy of both is severely threatened by widespread resistance of vectors to currently-approved insecticides and spreading resistance of parasites to currently- approved drugs. We hypothesize that malaria control can be enhanced, and the spread of both insecticide resistance and antimalarial drug resistance can be curtailed, if vector and parasite control efforts are linked using the endectocide ivermectin that can target both organisms with another layer of combination therapy to each. Ivermectin is an antiparasitic drug that is safe and distributed to hundreds of millions of humans each year. It also efficiently kills malaria vectors that blood feed on treated people and strong evidence suggests it also has activity against the sporogonic and exoerythrocytic stages of Plasmodium. We will conduct a cluster randomized clinical trial in Burkina Faso to test whether repeated ivermectin mass drug administrations, integrated into a monthly delivery platform with the standard malaria control measures of seasonal malaria chemoprevention and insectide-treated bed net distribution in the Sahel, will reduce childhood malaria incidence and limit resistance in both mosquitoes and parasites.

项目概要/摘要 世纪之交以来加强疟疾控制工作已导致疟疾显着减少 发病率和死亡率。这一成功得益于长效杀虫剂的广泛分布 经过处理的蚊帐和有针对性的室内滞留杀虫剂喷洒，以消灭病媒并进行快速诊断 使用基于青蒿素的联合疗法治疗疟疾，以及针对疟疾的化学预防计划 孕妇和儿童。然而，疟疾控制工作却停滞不前，因为针对这两种疾病的计划 媒介和寄生虫没有很好地整合，两者的功效都受到广泛传播的严重威胁。 病媒对目前批准的杀虫剂的抗药性以及寄生虫对目前批准的杀虫剂的抗药性的传播 批准的药物。我们假设可以加强疟疾控制，并且这两种杀虫剂的传播 如果将病媒和寄生虫控制工作联系起来，可以减少耐药性和抗疟药物耐药性 内灭菌剂伊维菌素可以针对这两种生物体，对每种生物体进行另一层联合治疗。 伊维菌素是一种安全的抗寄生虫药物，每年分发给数亿人。它 还可以有效杀死以血液为食的疟疾病媒，并且强有力的证据表明它还具有 对疟原虫的孢子发生阶段和红细胞外阶段的活性。我们将进行集群随机 在布基纳法索进行的临床试验，测试是否将重复伊维菌素大规模给药纳入 每月交付平台，具有季节性疟疾化学预防和标准疟疾控制措施 在萨赫勒地区分发经过杀虫剂处理的蚊帐，将减少儿童疟疾发病率并限制抵抗力 在蚊子和寄生虫中。