Sumba Livestock Ivermectin for Malaria Control (SLIM) Project
The primary objective of this project is to assess the impact of ivermectin treatment of cattle and buffalo with standard and long-lasting formulations on the survival of wild Anopheles on Sumba Island, Indonesia.
The secondary objectives are:
- To characterize community perceptions of malaria, mass ivermectin treatment of livestock (ITL) and human ivermectin mass drug administration for malaria control
- Characterize the Anopheles feeding behaviors on Sumba to determine which species prefers to feed on humans, cattle, buffalo, and horses
- Characterize ivermectin pharmacokinetics in Indonesian cattle and buffalo following single administration of standard and long-lasting ivermectin formulations
Malaria elimination in Indonesia will require development of new vector control tools to combat the diversity of Anopheles malaria vectors. Ivermectin mass drug administration (MDA) to humans and mass insecticide treatment of livestock (ITL) have been proposed as malaria vector control tools. Ivermectin-treated hosts can kill blood-feeding Anopheles, shifting the mosquito population age structure, reducing the sporozoite rate, and therefore interrupting malaria transmission to people. Most of this evidence comes from studies in West Africa, but veterinary, clinical, or small-scale MDA trials in Asia, Southeast Asia, Latin America, and Oceania demonstrate that ivermectin at human- and animal-relevant concentrations can reduce survival of over twenty malaria vectors found worldwide. In Indonesia, ownership of medium-sized livestock is an increased risk for malaria and most Anopheles mosquitoes do not exclusively bite humans (i.e., opportunistic feeders), therefore mass ITL could be a powerful tool for reducing malaria transmission. We propose a series of preliminary investigations to assess the mosquito-lethal effectiveness against wild Anopheles and community acceptability of ITL with standard and long-lasting formulations in cattle and buffalo on Sumba Island.
Doses: Standard ivermectin 200 µg/kg; Long-lasting ivermectin 630 µg/kg
- Study type: Interventional (Veterinary Trial)
- Allocation: Non-randomized
- Intervention Model: Parallel assignment
- Masking: None (Open Label)
- Primary Purpose: Treatment
- Primary outcome: Ivermectin lethal concentration that kills 50% of wild Anopheles species found on Sumba Island.
- Secondary outcomes: Qualitative assessment of community perceptions of ITL and MDA; Proportion of wild Anopheles captured on humans, cattle, buffalo, and horses; Ivermectin area under the concentration curve (AUC) and peak concentration (Cmax) in Indonesian cattle and buffalo.