Ivermectin for the control and elimination of malaria

Ivermectin, a widely used endectocide, holds promise for malaria control by rendering blood-feeding Anopheles mosquitoes lethal, suggesting potential for mass drug administration (MDA) and mass ivermectin treatment of livestock (ITL). Discovered in 1973 from Streptomyces avermitilis , ivermectin targets glutamate-gated chloride ion channels, offering a novel mechanism against malaria vectors. Initial studies demonstrated significant Anopheles mortality when feeding on ivermectin-treated hosts, with field trials confirming reduced mosquito survival. Regional research highlights varied impacts, with significant reductions in key malaria vectors across Africa, Latin America and South-east Asia. Beyond lethality, ivermectin's sublethal effects include delayed feeding, inhibited parasite development and reduced fecundity, which collectively diminish malaria transmission. Combining ivermectin with antimalarials like dihydroartemisinin-piperaquine (DP) enhances mosquito mortality, while ITL provides a viable strategy for outdoor-feeding vectors. This chapter explores ivermectin's multifaceted role in accelerating global malaria elimination efforts.