Barcelona [Spain], August 16 (HBTV): A groundbreaking study has revealed that the mass administration of ivermectin — a drug long used against river blindness and scabies — can significantly reduce malaria transmission when combined with bed nets.

The BOHEMIA trial, the largest study on ivermectin for malaria to date, showed a 26% reduction in new malaria infections on top of existing bed net protection, providing strong evidence of the drug’s potential as a complementary tool in malaria control.

The project was coordinated by the Barcelona Institute for Global Health (ISGlobal), supported by the la Caixa Foundation, in collaboration with the Manhiça Health Research Centre (CISM) and the KEMRI-Wellcome Trust Research Programme. Results have been published in The New England Journal of Medicine.

Malaria burden and need for innovation

Malaria remains a global health crisis, with 263 million cases and 597,000 deaths in 2023. Current control tools — such as long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) — are becoming less effective due to insecticide resistance and mosquito behaviour shifts, with more bites occurring outdoors and at dawn or dusk.

This has intensified the call for new approaches. Ivermectin, already used against neglected tropical diseases such as onchocerciasis (river blindness) and lymphatic filariasis (elephantiasis), works by killing mosquitoes that feed on treated individuals.

How the trial worked

The Unitaid-funded BOHEMIA project conducted two mass drug administration (MDA) trials in high-malaria regions: Kwale County (Kenya) and Mopeia district (Mozambique).

Participants received a monthly dose of ivermectin (400 mcg/kg) for three months at the start of the rainy season.

• In Kenya, the trial focused on children aged 5–15.

• In Mozambique, the target group was children under five.

In Kwale, children who received ivermectin experienced 26% fewer malaria infections compared to those given albendazole, the control drug.

The study involved 20,000 participants and 56,000 treatments. Importantly, ivermectin showed a favourable safety profile, with no severe adverse events reported and only mild, temporary side effects consistent with prior use in neglected tropical disease campaigns.

Expert voices

“Ivermectin has shown great promise in reducing malaria transmission and could complement existing measures. With continued research, it could even contribute to elimination efforts,” said Carlos Chaccour, co-principal investigator of the BOHEMIA project.

Marta Maia, BOHEMIA’s lead entomologist from the University of Oxford, added: “The findings suggest ivermectin MDA could be a valuable complementary strategy, particularly where mosquito resistance to insecticides is rising.”

The results have been reviewed by the WHO Vector Control Advisory Group, which confirmed the trial’s impact and recommended further studies. Findings have also been shared with national health authorities considering the drug’s inclusion in malaria programmes.

(ANI)