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

项目总结/摘要 自进入世纪以来，加强了疟疾控制工作，使疟疾发病率显著下降 发病率和死亡率。这一成功是由于长效杀虫剂的广泛分发 驱虫蚊帐和有针对性的室内残留喷洒杀虫剂以消灭病媒以及快速诊断 和以青蒿素为基础的联合疗法治疗疟疾， 孕妇和儿童。然而，疟疾控制工作停滞不前， 病媒和寄生虫没有很好地结合在一起，两者的功效受到广泛传播的 病媒对目前批准的杀虫剂的抗药性和寄生虫对目前批准的杀虫剂的抗药性的传播- 批准的药物。我们假设疟疾控制可以得到加强， 如果将病媒和寄生虫控制工作联系起来， 杀内寄生虫剂伊维菌素，可以针对两种生物体，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 也有效地杀死疟疾病媒，血液喂养治疗的人，有力的证据表明，它也有 抗疟原虫孢子生殖期和红细胞外期的活性。我们将进行一个随机分组 布基纳法索的临床试验，以测试是否重复伊维菌素大规模给药，整合到一个 每月提供一个平台，提供季节性疟疾化学预防的标准疟疾控制措施， 在萨赫勒地区分发驱虫蚊帐将减少儿童疟疾发病率并限制抗药性 在蚊子和寄生虫身上。

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.